61. Aikenhead 2011: Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review

LLM response

20 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
Quotes: "We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
Reasoning: The authors state that they performed a systematic review, but they do not mention a protocol, ethics approval, or pre-determined research objectives.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention the process of study selection and data extraction.
Response: [No]

A3. Was a comprehensive literature search performed?
Quotes: "We searched PubMed, ISI Web of Science, Embase and the Cochrane Library to 6 September 2010, and hand-searched bibliographies."
Reasoning: The authors mention multiple databases and a supplementary strategy (hand-searching bibliographies), indicating a comprehensive search.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention whether they included grey literature in their search.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: No relevant quotes found.
Reasoning: The authors do not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years."
Reasoning: The authors provide some information about the included studies, but they do not provide detailed characteristics of each study.
Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention assessing the quality of the included studies.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention the quality of the included studies in their conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Formal meta-analysis was not attempted due to the marked heterogeneity of study designs and outcome measures among the included studies."
Reasoning: The authors did not perform a meta-analysis due to the heterogeneity of the studies.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention assessing publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quotes: "The project that led to this paper was funded by the WHO Health Evidence Network of the World Health Organization. The funder had no role in the design, analysis or interpretation of the study."
Reasoning: The authors disclose their funding source and state that the funder had no role in the study.
Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Effectiveness and cost-effectiveness of paediatric bariatric surgery: a systematic review"
Reasoning: The title identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: "Summary: Strong evidence for successful and cost-effective obesity management strategies is still generally lacking, leading the medical profession to rely increasingly on surgical options to treat obesity in children and adolescents. We performed a systematic review to examine the effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
Reasoning: The abstract provides a summary of the background, objectives, methods, and results, but does not include all the required elements such as study eligibility criteria, participants, interventions, limitations, and implications of key findings.
Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "During the last two decades the prevalence of childhood and adolescent obesity has grown rapidly in most regions of the world. Despite reports of levelling off in some countries (1–3), childhood obesity and its associated morbidities and costs are considerable and increasing in scale in many countries (4,5), particularly among socioeconomically disadvantaged segments of many populations (6). Obese children and adolescents are more likely than their normal weight peers to suffer endocrine, cardiovascular, pulmonary, orthopaedic, psychosocial and other complications associated with excessive weight, many of which persist into adulthood (7–9). While prevention of obesity must continue to be a policy goal, the treatment of those that are already obese is an issue requiring urgent attention."
Reasoning: The authors provide a rationale for the review in the context of the increasing prevalence of childhood obesity and its associated health risks.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "This systematic review examines the evidence on effectiveness of surgical interventions to treat obese children and adolescents, and whether they are cost-effective."
Reasoning: The authors state the objectives of the review, but they do not explicitly mention the PICOS elements.
Response: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: No relevant quotes found.
Reasoning: The authors do not mention a review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "Articles with an abstract in English and full text in Danish, English, French, or Norwegian language were eligible. In addition, subjects had to be 19 years of age. At least one postoperative weight loss measure had to be reported, with a minimum follow-up time of 1 year post surgery. Clinical guidelines, reviews, meta-analyses and commentary on surgical interventions to treat obesity were excluded, as was grey literature such as conference proceedings."
Reasoning: The authors specify the eligibility criteria for the studies, including language, age of subjects, outcome measures, follow-up time, and types of publications excluded.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "We searched PubMed, ISI Web of Science, Embase and the Cochrane Library to 6 September 2010, and hand-searched bibliographies."
Reasoning: The authors describe the databases they searched and the date of the last search, and they also mention hand-searching bibliographies.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: "Search strategies were developed with PubMed using title abstract [tiab] terms; Appendix 1 contains details of the search terms."
Reasoning: The authors mention the search strategy and refer to an appendix for details.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: No relevant quotes found.
Reasoning: The authors do not describe the process for selecting studies.
Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe the data collection process.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: No relevant quotes found.
Reasoning: The authors do not list or define the variables for which data were sought.
Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe methods for assessing risk of bias in individual studies.
Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: No relevant quotes found.
Reasoning: The authors do not state the principal summary measures.
Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "Formal meta-analysis was not attempted due to the marked heterogeneity of study designs and outcome measures among the included studies."
Reasoning: The authors did not perform a meta-analysis due to the heterogeneity of the studies.
Response: [NA]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: No relevant quotes found.
Reasoning: The authors do not specify any assessment of risk of bias across studies.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe any additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "The search strategy yielded 3724 citations of which 273 articles were identified as potentially relevant. Full copies of 247 of these papers were obtained; full copies of the remaining 26 (9.5%) publications of unknown eligibility were unobtainable despite numerous attempts. Examination of the full text of the 247 articles resulted in the exclusion of 210 studies for a variety of reasons including: no original data (n = 112), overlapping data (‘kin’ studies) (n = 13), no paediatric data (n = 65), less than 1 year of follow-up (n = 6), no weight-related surgical outcomes (n = 6), no surgical data (n = 4), foreign language (n = 2), non-bariatric surgery (n = 1) and grey literature (n = 1). Thirty-seven articles (11 case studies, 10 retrospective reviews, 8 cohorts, 3 cost studies, 2 prospective longitudinal trials, 1 longitudinal study, 1 retrospective cohort and 1 randomized controlled trial) were identified and included in the review."
Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "Thirty-seven relevant papers on bariatric surgery effectiveness in 831 children or adolescents were included, spanning 36 years."
Reasoning: The authors provide some information about the included studies, but they do not provide detailed characteristics of each study.
Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: No relevant quotes found.
Reasoning: The authors do not present data on risk of bias within studies.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: "Thirteen studies examined gastric banding, with mean body mass index (BMI) reductions ranging from 8.5 to 43 kg m-2. Weight gain was reported in one case study. Eight papers examined Roux-en-Y gastric bypass, with mean BMI reductions ranging from 9 to 25 kg m-2. Fourteen publications studied other forms of bariatric surgery: sleeve gastrectomies, vertical banded gastroplasty, biliopancreatic diversion or a combination of procedures. Mean BMI reductions ranged from 9 to 24 kg m-2."
Reasoning: The authors present summary data for each intervention group, but they do not provide effect estimates and confidence intervals.
Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: "Formal meta-analysis was not attempted due to the marked heterogeneity of study designs and outcome measures among the included studies."
Reasoning: The authors did not perform a meta-analysis due to the heterogeneity of the studies.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: No relevant quotes found.
Reasoning: The authors do not present results of any assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: No relevant quotes found.
Reasoning: The authors do not present results of any additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: "The existing evidence – although based generally on underpowered, retrospective studies – suggests that bariatric surgery in older children results in significant weight loss and improvements in comorbidities and quality of life."
Reasoning: The authors summarize the main findings and discuss the strength of the evidence.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "This study was challenging due to a number of limitations in the existing literature: Studies assessing the effectiveness of surgical options for obesity in children and adolescents were (apart from one randomized controlled trial) either retrospective or observational, and systematically underpowered. Sample sizes were generally small, with the largest sample containing only 68 patients and the majority of studies reporting data on fewer than 40 patients. Results were not broadly comparable given a lack of consistency across surgeons, procedures and reported outcomes. Accurate information for low frequency outcomes like mortality and complications was sparse. No studies on clinical effectiveness reported on costs, and only one study addressed bariatric surgery cost in children."
Reasoning: The authors discuss the limitations of the study, including the quality of the included studies, small sample sizes, and lack of cost data.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "In the context of a general lack of effective tools for primary prevention or behavioural treatment of obesity, surgical treatment may be advocated as a preferred and cost-effective solution for certain children and adolescents. However, postoperative complications, compliance and follow-up may be more problematic in adolescents than adults, and availability of long-term data on safety, effectiveness and cost-effectiveness remains largely unknown. Pending an improvement in the quality of available evidence, an academic approach to child and adolescent bariatric surgery is warranted, and reversible techniques are advisable compared to approaches that permanently alter the anatomy."
Reasoning: The authors provide a general interpretation of the results and discuss the implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: "The project that led to this paper was funded by the WHO Health Evidence Network of the World Health Organization. The funder had no role in the design, analysis or interpretation of the study."
Reasoning: The authors disclose the source of funding for the review and state that the funder had no role in the study.
Response: [Yes]

62. Al-Hozaim 2010: Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting

LLM response

17 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
Quotes: "The aim of this study was to conduct a systematic review to evaluate the worldwide experience with LAARP with regard to indications, outcomes, and quality of reporting in published articles."
Reasoning: The authors stated the aim of the systematic review, but did not mention a protocol or pre-determined research objectives.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention the process of study selection and data extraction.
Response: [No]

A3. Was a comprehensive literature search performed?
Quotes: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted. The search terms used were “laparoscopic,” “pull-through,” “anorectal malformation,” and “imperforate anus.” In addition, a manual search of 4 surgical journals from the same period was performed."
Reasoning: The authors described the databases and search terms used, and also performed a manual search of specific journals.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention whether they included grey literature in their search.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: No relevant quotes found.
Reasoning: The authors did not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "Seventeen studies were included in the final analysis. Of the included studies, none were randomized, 2 were prospective in nature, and 4 compared outcomes of posterior sagittal anorectoplasty and LAARP."
Reasoning: The authors provided some characteristics of the included studies, such as the number of studies and their design.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention any assessment of the scientific quality of the included studies.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention the scientific quality of the included studies in their conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Because of the marked variation in the outcome measures (Table 3), it was not possible to perform a formal meta-analysis."
Reasoning: The authors did not combine the findings of the studies due to variation in outcome measures.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention any assessment of publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention any conflicts of interest.
Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Laparoscopic-assisted anorectal pull-through for anorectal malformations: a systematic review and the need for standardization of outcome reporting"
Reasoning: The title identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: The abstract provides a summary of the background, objectives, methods, results, and conclusions.
Reasoning: The abstract provides a structured summary of the systematic review.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "Recently, several studies on LAARP have been reported, and although there has been an increase in interest, the level of evidence supporting the technique remains unclear. The aim of this study was to conduct a systematic review to evaluate the worldwide experience with LAARP with regard to indications, outcomes, and quality of reporting in published articles."
Reasoning: The authors provided the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "The aim of this study was to conduct a systematic review to evaluate the worldwide experience with LAARP with regard to indications, outcomes, and quality of reporting in published articles."
Reasoning: The authors provided an explicit statement of the questions being addressed, but did not reference PICOS.
Response: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: No relevant quotes found.
Reasoning: The authors did not mention a review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "Inclusion criteria were studies of ARMs, regardless of level of the defect, with or without associated anomalies, use of LAARP as a primary procedure or with colostomy, and studies reported after the year 2000. Exclusion criteria included studies that were not reported in English and those that did not deal with human subjects."
Reasoning: The authors specified the study and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "A systematic search of the MEDLINE, PUBMED, and Cochrane databases (June 2000 to April 2008) was conducted. The search terms used were “laparoscopic,” “pull-through,” “anorectal malformation,” and “imperforate anus.” In addition, a manual search of 4 surgical journals from the same period was performed."
Reasoning: The authors described the information sources and the date of the last search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: "The search terms used were “laparoscopic,” “pull-through,” “anorectal malformation,” and “imperforate anus.”"
Reasoning: The authors presented the search terms used, but did not provide a full electronic search strategy that could be repeated.
Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: "The initial search in the PUBMED database produced 24 articles, 11 of which met the inclusion criteria. The MEDLINE search resulted in 2 additional new studies, whereas the search of the Cochrane database did not yield any studies. The manual search of the 4 journals captured an additional 1 study from the Journal of Pediatric Surgery and 1 study from Pediatric Surgery International. Two additional articles were found in reference sections of other studies, bringing the total number of studies to 17."
Reasoning: The authors described the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: No relevant quotes found.
Reasoning: The authors did not describe the method of data extraction from reports.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: "A data extraction form was created to standardize the collection of study elements from each included article. This form included the following information: inclusion/exclusion criteria, study title, author, characteristics of the journal (year of publication), study design, study period, sample size, and the focus of the study in use of the LAARP as a primary procedure or after colostomy."
Reasoning: The authors listed and defined the variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: No relevant quotes found.
Reasoning: The authors did not describe methods used for assessing risk of bias of individual studies.
Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: No relevant quotes found.
Reasoning: The authors did not state the principal summary measures.
Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "Because of the marked variation in the outcome measures (Table 3), it was not possible to perform a formal meta-analysis."
Reasoning: The authors did not combine the results of studies due to variation in outcome measures.
Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: No relevant quotes found.
Reasoning: The authors did not specify any assessment of risk of bias across studies.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: No relevant quotes found.
Reasoning: The authors did not describe any additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "The initial search in the PUBMED database produced 24 articles, 11 of which met the inclusion criteria. The MEDLINE search resulted in 2 additional new studies, whereas the search of the Cochrane database did not yield any studies. The manual search of the 4 journals captured an additional 1 study from the Journal of Pediatric Surgery and 1 study from Pediatric Surgery International. Two additional articles were found in reference sections of other studies, bringing the total number of studies to 17."
Reasoning: The authors gave numbers of studies screened, assessed for eligibility, and included in the review, but did not provide reasons for exclusions at each stage or a flow diagram.
Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "Seventeen studies were included in the final analysis. Of the included studies, none were randomized, 2 were prospective in nature, and 4 compared outcomes of posterior sagittal anorectoplasty and LAARP."
Reasoning: The authors presented some characteristics of the included studies, but did not provide the citations.
Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: No relevant quotes found.
Reasoning: The authors did not present data on risk of bias of each study.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: "The studies included 124 patients—96 males (77.4%) and 28 females (22.6%). Of the 124 patients, 110 (88.7%) had undergone previous colostomy, whereas 14 patients (11.2%) had undergone a primary laparoscopic repair without a colostomy. Most patients (80%) had either a high or intermediate ARM."
Reasoning: The authors presented some summary data for each study, but did not provide effect estimates and confidence intervals.
Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: "Because of the marked variation in the outcome measures (Table 3), it was not possible to perform a formal meta-analysis."
Reasoning: The authors did not perform a meta-analysis.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: No relevant quotes found.
Reasoning: The authors did not present results of any assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: No relevant quotes found.
Reasoning: The authors did not give results of any additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: "We conclude that there is an urgent need to increase the number of studies reporting LAARP-related outcomes. More efforts are needed by the pediatric surgery community to improve the quality of studies and standardization of reports related ARM."
Reasoning: The authors summarized the main findings and considered their relevance to the pediatric surgery community.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "Our study has several limitations. First, this is a systematic review of mainly retrospective data. The quality of such review is only as good as the included studies. Second, because of the wide variation of reported outcomes, no formal meta-analysis and calculation of summary statistics could be performed. Finally, our review only included articles published in English, which may have contributed to a selection bias by omitting relevant articles published in other languages."
Reasoning: The authors discussed the limitations of their systematic review.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "We conclude that there is an urgent need to increase the number of studies reporting LAARP-related outcomes. More efforts are needed by the pediatric surgery community to improve the quality of studies and standardization of reports related ARM."
Reasoning: The authors provided a general interpretation of the results and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: No relevant quotes found.
Reasoning: The authors did not describe sources of funding for the systematic review.
Response: [No]

63. Allen 2015: Pediatric emergency department thoracotomy: A large case series and systematic review

LLM response

12 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
Quote: "We reviewed our experience and performed a systematic review of reports of EDT in pediatric patients."
Reasoning: The authors mention a systematic review but do not provide any information about a pre-established protocol or research question.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quote: Not available.
Reasoning: The text does not provide information about the study selection and data extraction process.
Response: [No]

A3. Was a comprehensive literature search performed?
Quote: "These reports were obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 year using the keywords “thoracotomy”, “emergency”, “trauma”, “resuscitation”, “pediatrics”, and “children”. Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: The authors describe a comprehensive literature search using multiple keywords and checking bibliographies of relevant publications.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: Not available.
Reasoning: The text does not provide information about the inclusion of grey literature in the search strategy.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quote: Not available.
Reasoning: The text does not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quote: "Variables extracted from each report include demographics, MOI, injury location, presence of VS and/or SOL upon arrival, ROSC, survival to discharge, and neurologic outcomes for survivors."
Reasoning: The authors describe the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: Not available.
Reasoning: The text does not provide information about the assessment of the scientific quality of the included studies.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quote: Not available.
Reasoning: The text does not provide information about the use of the scientific quality of the included studies in formulating conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: Not available.
Reasoning: The text does not provide information about the methods used to combine the findings of the studies.
Response: [No]

A10. Was the likelihood of publication bias assessed?
Quote: Not available.
Reasoning: The text does not provide information about the assessment of publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quote: Not available.
Reasoning: The text does not provide information about the conflict of interest.
Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Pediatric emergency department thoracotomy: A large case series and systematic review"
Reasoning: The title identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quote: The abstract provides a structured summary including background, objectives, data sources, methods, results, and conclusions.
Reasoning: The abstract provides a structured summary including background, objectives, data sources, methods, results, and conclusions.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quote: "The emergency department thoracotomy (EDT) is rarely utilized in children, and is thus difficult to identify survival factors. We reviewed our experience and performed a systematic review of reports of EDT in pediatric patients."
Reasoning: The authors describe the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quote: "To address this issue, we reviewed our experience at a level 1 trauma center and report the largest analysis over the past 25 years. In conjunction, we performed a systematic review of all published reports regarding pediatric EDT to help identify the factors associated with morbidity and mortality."
Reasoning: The authors provide an explicit statement of the questions being addressed.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quote: Not available.
Reasoning: The text does not provide information about a review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quote: "With respect to our institution, we analyzed all pediatric patients (age ≤ 18) who received an EDT from 1991 to 2012."
Reasoning: The authors specify the study characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quote: "These reports were obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 year using the keywords “thoracotomy”, “emergency”, “trauma”, “resuscitation”, “pediatrics”, and “children”. Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: The authors describe the information sources used in the search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quote: "These reports were obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 year using the keywords “thoracotomy”, “emergency”, “trauma”, “resuscitation”, “pediatrics”, and “children”. Bibliographies of relevant publications were reviewed to identify reports that were not initially located with the Medline search."
Reasoning: The authors present the electronic search strategy for Medline.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quote: Not available.
Reasoning: The text does not provide information about the process for selecting studies.
Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quote: Not available.
Reasoning: The text does not provide information about the data collection process.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quote: "Variables extracted from each report include demographics, MOI, injury location, presence of VS and/or SOL upon arrival, ROSC, survival to discharge, and neurologic outcomes for survivors."
Reasoning: The authors list and define all variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quote: Not available.
Reasoning: The text does not provide information about the methods used for assessing risk of bias of individual studies.
Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quote: Not available.
Reasoning: The text does not provide information about the principal summary measures.
Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quote: Not available.
Reasoning: The text does not provide information about the methods of handling data and combining results of studies.
Response: [No]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quote: Not available.
Reasoning: The text does not provide information about the assessment of risk of bias across studies.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quote: Not available.
Reasoning: The text does not provide information about additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quote: Not available.
Reasoning: The text does not provide information about the number of studies screened, assessed for eligibility, and included in the review.
Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quote: "Variables extracted from each report include demographics, MOI, injury location, presence of VS and/or SOL upon arrival, ROSC, survival to discharge, and neurologic outcomes for survivors."
Reasoning: The authors present the characteristics for which data were extracted for each study.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quote: Not available.
Reasoning: The text does not provide information about the risk of bias within studies.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quote: Not available.
Reasoning: The text does not provide simple summary data for each intervention group or effect estimates and confidence intervals for each study.
Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quote: Not available.
Reasoning: The text does not provide results of a meta-analysis.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quote: Not available.
Reasoning: The text does not provide results of an assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quote: Not available.
Reasoning: The text does not provide results of additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quote: "From our experiences and upon review of published reports, we have come to several conclusions. Overall, the mortality rates are comparable between adults and pediatric patients following EDT."
Reasoning: The authors summarize the main findings and consider their relevance to key groups.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quote: "There are limitations to this study. First, all of the data obtained from our institution were collected retrospectively, and thus not specifically collected for research purposes."
Reasoning: The authors discuss the limitations of the study.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quote: "Despite these limitations, this is one of the largest series report and the first systematic review regarding pediatric EDT. The lack of extensive experience with this resuscitative measure in children and adolescents still prohibits the establishment of guidelines specific to this population."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quote: Not available.
Reasoning: The text does not provide information about the sources of funding for the systematic review.
Response: [No]

64. Allin 2015: Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management

LLM response

29 quote(s) from publication full text (mean similarity 96.7%)

A1. Was an 'a priori' design provided?
Quote: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The authors mention a pre-specified protocol that was registered on Prospero.
Response: [Yes]

A2. Was there duplicate study selection and data extraction?
Quote: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion."
Reasoning: The authors describe a process of independent study selection and data extraction by two investigators, with a third investigator resolving any conflicts.
Response: [Yes]

A3. Was a comprehensive literature search performed?
Quote: "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012."
Reasoning: The authors describe a comprehensive search strategy across multiple databases.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quote: No specific mention of grey literature search.
Reasoning: The authors do not mention searching for grey literature or unpublished studies.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quote: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies."
Reasoning: The authors provide a summary of the number of studies identified, included, and excluded, but do not provide a full list of these studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quote: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR."
Reasoning: The authors provide some characteristics of the included studies, such as the total number of infants and the interventions they underwent.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The authors mention using the STROBE checklist and GRADE criteria to assess the quality and risk of bias of the included studies.
Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quote: "Our results would appear to suggest a potential benefit to OPFC over SR. However, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
Reasoning: The authors acknowledge the limitations and quality of the included studies in their conclusions.
Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quote: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook."
Reasoning: The authors mention using standard methods for data synthesis as described in the Cochrane Reviewers Handbook.
Response: [Yes]

A10. Was the likelihood of publication bias assessed?
Quote: No specific mention of assessing publication bias.
Reasoning: The authors do not mention assessing for publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quote: "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist."
Reasoning: The authors disclose their funding sources and declare no competing interests.
Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quote: "Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management"
Reasoning: The title clearly identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quote: "Abstract: Objective: To identify methods of improving the evidence base in smaller surgical specialties, using a systematic review of gastroschisis management as an example. Background: Operative primary fascial closure (OPFC), and silo placement with staged reduction and delayed closure (SR) are the most commonly used methods of gastroschisis closure. Relative merits of each are unclear. Methods: A systematic review and meta-analysis was performed comparing outcomes following OPFC and SR in infants with simple gastroschisis. Primary outcomes of interest were mortality, length of hospitalization and time to full enteral feeding. Results: 751 unique articles were identified. Eight met the inclusion criteria. None were randomized controlled trials. 488 infants underwent OPFC and 316 underwent SR. Multiple studies were excluded because they included heterogeneous populations and mixed intervention groups. Length of stay was significantly longer in the SR group (mean difference 8.97 days, 95% CI 2.14–15.80 days), as was number of post-operative days to complete enteral feeding (mean difference 7.19 days, 95%CI 2.01–12.36 days). Mortality was not statistically significantly different, although the odds of death were raised in the SR group (OR 1.96, 95%CI 0.71–5.35). Conclusions: Despite showing some benefit of OPFC over SR, our results are tempered by the low quality of the available studies, which were small and variably reported. Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
Reasoning: The abstract provides a structured summary of the background, objectives, methods, results, and conclusions.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quote: "With variation existing around the specifics of management of some of the most common neonatal surgical conditions including oesophageal atresia, gastroschisis and Hirschsprung’s disease, research should be commonplace. Yet despite these fertile conditions for research, for these three conditions, only fourteen prospectively registered clinical trials and two systematic reviews could be identified on a search of the major registries at the time of writing (Table 1). Whilst both the low incidence of many of the studied conditions, and the difficulties in gaining ethical approval are at least in part responsible for the lack of paediatric surgical research, we do not believe that they account for the whole story."
Reasoning: The authors provide a rationale for the review in the context of the current state of research in the field.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quote: "The aim of this study, therefore, was to perform a systematic review of the literature comparing outcomes of infants with simple gastroschisis following either OPFC or SR. From this study we aimed to identify some of the reasons why research in paediatric surgery is currently largely unable to provide a strong evidence base to inform clinical practice."
Reasoning: The authors provide an explicit statement of the research question, including the participants (infants with simple gastroschisis), interventions (OPFC or SR), and outcomes (reasons why research in paediatric surgery is currently largely unable to provide a strong evidence base to inform clinical practice).
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quote: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
Reasoning: The authors indicate that a review protocol exists and provide the registration number.
Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quote: "All study designs except expert opinion were included, and no restrictions were made on the basis of study language or geographical location. Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest. Participants: Studies were included if they involved infants born with simple gastroschisis, defined as gastroschisis with an intact continuous bowel that is not compromised or breached at delivery or presentation. Infants with complex gastroschisis, defined as the presence of at least one of intestinal perforation, necrosis, or atresia were excluded from this review, as they only account for approximately 11.5% of infants with gastroschisis, are known to have a worse prognosis than the majority with simple gastroschisis, and thus represent a major confounder in any examination of the outcomes of different management techniques."
Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quote: "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012."
Reasoning: The authors describe the information sources and the dates of coverage for their search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quote: "Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospitali
 ischaemic bowel, complications), and were combined using Boolean operators."
Reasoning: The authors present their search strategy, including the search terms and the use of Boolean operators.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quote: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion."
Reasoning: The authors describe the process for selecting studies, including independent assessment by two investigators and resolution of conflicts by a third investigator.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quote: "Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences resolved by discussion. Where required, unpublished data were requested from the authors of each of the included studies to allow for meta-analysis."
Reasoning: The authors describe the method of data extraction, including independent extraction by two investigators and resolution of differences through discussion.
Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quote: "Primary outcome measures: 1. Mortality 2. Length of hospital stay 3. Time to complete enteral feeding/duration of parenteral feeding Secondary outcome measures: 1. Duration of ventilator use 2. Infective complication 3. Perforation 4. Ischaemic bowel 5. Necrotising Enterocolitis (NEC) 6. Anastomotic stricture 7. Adhesional small bowel obstruction 8. Complications related to stoma 9. Short bowel syndrome 10. Liver disease associated with intestinal failure"
Reasoning: The authors list and define all the variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
Reasoning: The authors describe the methods used for assessing the risk of bias in individual studies.
Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quote: "Dichotomous outcomes were meta-analysed using Mantel–Haenszel fixed effects methods to produce summary odds ratios with 95% confidence intervals. Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
Reasoning: The authors state the principal summary measures used in their analysis.
Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quote: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout."
Reasoning: The authors describe the methods of handling data and combining results of studies.
Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quote: No specific mention of assessing risk of bias across studies.
Reasoning: The authors do not mention assessing risk of bias across studies.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quote: No specific mention of additional analyses.
Reasoning: The authors do not mention conducting any additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quote: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria, all of which were cohort studies."
Reasoning: The authors provide the numbers of studies screened, assessed for eligibility, and included in the review.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quote: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR. The largest study was Owen 2010 with 290 eligible patients. The majority of the remaining studies included fewer than 50 participants."
Reasoning: The authors present the characteristics of the included studies, including the study size and interventions.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quote: No specific mention of presenting data on risk of bias within each study.
Reasoning: The authors do not present data on the risk of bias within each study.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quote: "All three primary outcome measures appeared to favour the OPFC group over the SR group. Both length of stay and number of post-operative days to complete enteral feeding were clinically and statistically significantly longer in the SR group, with a mean difference of 8.97 days, (95% CI 2.14–15.80 days), and a mean difference of 7.19 days (95%CI 2.01–12.36 days) respectively."
Reasoning: The authors present the results of individual studies, including summary data for each intervention group and effect estimates with confidence intervals.
Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quote: "All three primary outcome measures appeared to favour the OPFC group over the SR group. Both length of stay and number of post-operative days to complete enteral feeding were clinically and statistically significantly longer in the SR group, with a mean difference of 8.97 days, (95% CI 2.14–15.80 days), and a mean difference of 7.19 days (95%CI 2.01–12.36 days) respectively."
Reasoning: The authors present the results of their meta-analysis, including confidence intervals.
Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quote: No specific mention of presenting results of assessment of risk of bias across studies.
Reasoning: The authors do not present results of any assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quote: No specific mention of additional analyses.
Reasoning: The authors do not mention conducting any additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quote: "Our results would appear to suggest a potential benefit to OPFC over SR. However, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
Reasoning: The authors summarize the main findings and discuss the strength of the evidence.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quote: "This study has highlighted three key themes that recur throughout research into paediatric surgery, and which help account for the lack of a robust evidence base for clinical practice. These are; limitations of study type, limitations of methodology, and inconsistency in outcomes and definitions."
Reasoning: The authors discuss the limitations of their study, including the study type, methodology, and inconsistency in outcomes and definitions.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quote: "Our results would appear to suggest a potential benefit to OPFC over SR. However, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
Reasoning: The authors provide a general interpretation of the results and discuss the implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quote: "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
Reasoning: The authors describe the sources of funding for the systematic review.
Response: [Yes]

65. Alzahem 2011: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

LLM response

25 quote(s) from publication full text (mean similarity 99.2%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of this study was to assess any differences in complication rates and outcome following surgery for indirect inguinal hernia between infants and children treated using the open and laparoscopic techniques. We performed a systematic review and meta-analysis of the existing evidence."
- Reasoning: The authors clearly state their research question and aim of the study.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
- Reasoning: The authors mention that two authors independently assessed articles and extracted data.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
- Reasoning: The authors describe a comprehensive search strategy across multiple databases.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No specific mention of grey literature.
- Reasoning: The authors do not mention searching for grey literature or including unpublished studies.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: No specific mention of a list of included and excluded studies.
- Reasoning: The authors do not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Ten published studies were identified (Niyogi [19]; Tsai [20]; Koivusalo [21]; Endo [22]; Bharathi [23]; Hassan [24]; Koivusalo [25]; Chan [17]; Oue [26]; Antao [27]) in which the laparoscopic and open approaches for repair of pediatric inguinal hernias were directly compared."
- Reasoning: The authors provide a list of the included studies but do not provide detailed characteristics of these studies.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
- Reasoning: The authors describe the methods used to assess the quality of the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "Our review’s conclusions are hampered by the quality and the small sample size of the most included studies."
- Reasoning: The authors acknowledge the limitations of the included studies in their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "For dichotomous outcomes, odds ratio (OR) and its associated confidence interval were calculated. For continuous outcomes, treatment effect was expressed as mean difference and its calculated standard deviation. If appropriate, meta-analysis of pooled data of the comparative studies was performed using a fixed effect model."
- Reasoning: The authors describe the statistical methods used to combine the findings of the included studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No specific mention of assessing publication bias.
- Reasoning: The authors do not mention assessing for publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: No specific mention of conflict of interest.
- Reasoning: The authors do not mention any conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis"
- Reasoning: The title clearly identifies the report as a meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: The abstract provides a summary of the background, objectives, methods, results, and conclusions.
- Reasoning: The abstract provides a structured summary of the study.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Inguinal hernia repair is one of the most frequently performed pediatric surgical operations [1]. Open repair of an inguinal hernia has been accepted as the method of choice since it was first described more than 50 years ago due to its lower morbidity, good cosmesis, and lower rates of recurrence [2–4]. Several pediatric laparoscopic inguinal hernia repair techniques have been introduced over the last few years [5–15]."
- Reasoning: The authors provide a rationale for the review in the context of existing knowledge.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of this study was to assess any differences in complication rates and outcome following surgery for indirect inguinal hernia between infants and children treated using the open and laparoscopic techniques."
- Reasoning: The authors provide an explicit statement of the research question.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No specific mention of a review protocol or registration.
- Reasoning: The authors do not mention a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "All comparative studies of the laparoscopic and open approaches for indirect inguinal hernia in children aged less than 19 years were selected. The primary outcome measure was the recurrence rate."
- Reasoning: The authors specify the eligibility criteria for the studies included in the review.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "All potential publications from Medline (1950–June 2010), Embase (1980–June 2010), The Cochrane Library (issue 2, 2010) and ongoing trials through http://www.clinicaltrials.gov website were identified."
- Reasoning: The authors describe the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The following subject headings (MeSH) and text word terms were utilized: inguinal hernia, laparoscopy, minimal access surgery, infant(s), neonate(s), newborn(s), child, paediatric, pediatric. No language restriction was applied."
- Reasoning: The authors present their search strategy, including the terms used.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Retrieved articles were assessed for eligibility and data on patients, intervention, control, outcomes and methodological quality were abstracted independently by two authors. Discrepancies were resolved by discussion and consensus."
- Reasoning: The authors describe the data extraction process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The primary outcome measure was the recurrence rate. Other clinically important outcomes such as rate of contralateral PPV, operative time, postoperative pain and recovery, cosmesis, postoperative testicular atrophy, postoperative hydrocele and stitch granuloma/abscess were also sought."
- Reasoning: The authors list and define the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
- Reasoning: The authors describe the methods used to assess the risk of bias in the included studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "For dichotomous outcomes, odds ratio (OR) and its associated confidence interval were calculated. For continuous outcomes, treatment effect was expressed as mean difference and its calculated standard deviation."
- Reasoning: The authors state the principal summary measures used in the review.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "If appropriate, meta-analysis of pooled data of the comparative studies was performed using a fixed effect model. Review Manager 5.0.24 software was used for statistical analysis. Heterogeneity was defined as a significant test of heterogeneity (p \ 0.1) and/or differences in the treatment effects across studies. Tests for between study heterogeneity (including the I2 test) were performed. When statistical heterogeneity existed, a random effect model was utilized."
- Reasoning: The authors describe the methods used to handle data and combine results of studies.
- Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No specific mention of assessing risk of bias across studies.
- Reasoning: The authors do not mention assessing risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76]."
- Reasoning: The authors describe a sensitivity analysis that was conducted.
- Response: [Yes]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Initial electronic search yielded 290 Medline, 216 Embase, 5 Cochrane Library (issue 2, 2010) and 7 ClinicalTrials.gov potentially relevant citations. After screening the abstracts, 48 articles were reviewed in full texts. Thirty-four articles have met the predefined inclusion criteria."
- Reasoning: The authors provide numbers of studies screened, assessed for eligibility, and included in the review, but do not provide a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Ten published studies were identified (Niyogi [19]; Tsai [20]; Koivusalo [21]; Endo [22]; Bharathi [23]; Hassan [24]; Koivusalo [25]; Chan [17]; Oue [26]; Antao [27]) in which the laparoscopic and open approaches for repair of pediatric inguinal hernias were directly compared."
- Reasoning: The authors provide a list of the included studies but do not provide detailed characteristics of these studies.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "The quality of the included comparative studies was assessed independently by two authors. The Cochrane Collaboration criteria for randomized controlled trials was utilized (randomization, allocation concealment, blinding and completeness of follow-up). Cohort studies were assessed using the Newcastle-Ottawa Quality Assessment Scale [18]."
- Reasoning: The authors present data on the risk of bias of each study.
- Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "In a meta-analysis of 10 comparative studies, there was a trend towards higher recurrence rate for the laparoscopic inguinal hernia repair [OR = 1.81; 95% CI 0.89–3.67; p = 0.10]."
- Reasoning: The authors present summary data and effect estimates for each study.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "In a meta-analysis of 10 comparative studies, there was a trend towards higher recurrence rate for the laparoscopic inguinal hernia repair [OR = 1.81; 95% CI 0.89–3.67; p = 0.10]."
- Reasoning: The authors present the results of the meta-analysis, including confidence intervals.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No specific mention of assessing risk of bias across studies.
- Reasoning: The authors do not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: "A sensitivity analysis was conducted where studies limited to girls, and/or with a median follow-up less than 6 months, and/or addressing a complicated hernia, and/or limited to infants were excluded and the meta-analysis of the remaining 6 comparative studies had shown a comparable recurrence rate among the groups [OR = 0.87; 95% CI 0.34–2.23; p = 0.76]."
- Reasoning: The authors present the results of a sensitivity analysis.
- Response: [Yes]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Our review examined the safety and efficacy of the laparoscopic approach in the management of inguinal hernias in infants and children. Ten comparative studies were reviewed. Although the data is limited, the laparoscopic approach was associated with a trend towards higher recurrence rate."
- Reasoning: The authors summarize the main findings of the review.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Our review’s conclusions are hampered by the quality and the small sample size of the most included studies."
- Reasoning: The authors discuss the limitations of the review.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "We were unable to identify any clear benefit of laparoscopic inguinal herniotomy over the open approach. This review brings to light the paucity of existing good-quality evidence in this area. A large-scale randomized well-powered clinical trial comparing the two approaches should be conducted to guide our practice."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No specific mention of funding.
- Reasoning: The authors do not mention any sources of funding for the review.
- Response: [No]

66. Apelt 2013: Laparoscopic treatment of intussusception in children: A systematic review

LLM response

25 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
Quotes: "By reviewing available data we aimed to establish whether laparoscopy should be the primary technique in the surgical reduction of intussusception."
Reasoning: The authors state their research question and aim, but there is no mention of a protocol or pre-determined research objectives.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quotes: "Results were confirmed by a second independent search by a different member of the team using matching search strings and databases."
Reasoning: The authors mention a second independent search, suggesting duplicate study selection, but there is no explicit mention of duplicate data extraction.
Response: [No]

A3. Was a comprehensive literature search performed?
Quotes: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed."
Reasoning: The authors describe a comprehensive literature search in multiple databases.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention searching for grey literature or including/excluding studies based on publication status.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: No relevant quotes found.
Reasoning: The authors do not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "Table 1 provides specific details on the selected studies."
Reasoning: The authors provide a table with details on the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "All 10 studies were level IIB evidence (Oxford Centre for Evidence-based Medicine)."
Reasoning: The authors mention the level of evidence of the included studies, indicating an assessment of their scientific quality.
Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "This allowed this structured review to draw conclusions at the C level of evidence (UK National Health Service grading system for medical evidence and treatment recommendations), corresponding to a level II-2 treatment recommendation by the US Preventive Services Task Force (USPSTF)."
Reasoning: The authors mention that the level of evidence of the included studies was considered in formulating their conclusions.
Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: The authors did not perform a meta-analysis due to the absence of randomized controlled trials and the heterogeneity of the studies.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention assessing the likelihood of publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quotes: No relevant quotes found.
Reasoning: The authors do not mention potential sources of support or conflicts of interest for the systematic review or the included studies.
Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Laparoscopic treatment of intussusception in children: A systematic review"
Reasoning: The title identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: "Abstract: Background: Idiopathic intussusception is one of the most common causes of small bowel obstruction in children" [...] "Conclusion: Laparoscopy is safe and effective in the treatment of pediatric intussusception."
Reasoning: The abstract provides a structured summary including background, objectives, methods, results, and conclusions.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "Idiopathic intussusception is the single most common cause of small bowel obstruction in children younger than 5 years" [...] "However, in the case of intussusception the lack of data about safety, efficacy, risks and outcome of laparoscopy has limited its use."
Reasoning: The authors describe the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "By reviewing available data we aimed to establish whether laparoscopy should be the primary technique in the surgical reduction of intussusception."
Reasoning: The authors provide an explicit statement of the question being addressed.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: No relevant quotes found.
Reasoning: The authors do not mention a review protocol or registration information.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "Exclusion criteria were non-English language articles, case reports, laparoscopic-assisted enema reduction and mixed pediatric and adult populations (age cutoff 18 years)."
Reasoning: The authors specify the eligibility criteria for the studies included in the review.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "An online database search for all English language articles on pediatric small bowel obstruction, intussusception and laparoscopy in PubMed, Medline and Ovid from January 1990 to April 2012 was performed."
Reasoning: The authors describe the information sources and the date range of the search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: No relevant quotes found.
Reasoning: The authors do not present a full electronic search strategy that could be repeated.
Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: "Results were confirmed by a second independent search by a different member of the team using matching search strings and databases."
Reasoning: The authors state the process for selecting studies, but do not provide detailed information about screening and eligibility.
Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe the method of data extraction or any processes for obtaining and confirming data.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: "The following variables were analyzed: age, laparoscopic success rate, reason for conversion, enterotomy rate, operative time, complications, and length of stay (LOS)."
Reasoning: The authors list and define the variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe methods used for assessing risk of bias of individual studies.
Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: The authors do not state the principal summary measures, as a meta-analysis was not performed.
Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: The authors do not describe methods of handling data and combining results of studies, as a meta-analysis was not performed.
Response: [NA]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: No relevant quotes found.
Reasoning: The authors do not specify any assessment of risk of bias that may affect the cumulative evidence.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe methods of additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "Overall, 10 studies were identified which included a total of 276 cases of laparoscopically treated intussusception."
Reasoning: The authors give the number of studies included in the review, but do not provide numbers of studies screened, assessed for eligibility, or excluded, nor do they provide a flow diagram.
Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "Table 1 provides specific details on the selected studies."
Reasoning: The authors provide a table with details on the included studies.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: No relevant quotes found.
Reasoning: The authors do not present data on risk of bias of each study.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: "Ten retrospective studies treating 276 cases of laparoscopically reduced intussusception were identified. A total of 80 conversions corresponded to a 71.0% laparoscopic success rate."
Reasoning: The authors present summary data for each study, but do not provide effect estimates and confidence intervals for each study.
Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: "Owing to the absence of any randomized controlled trials and the heterogeneous nature of studies, a formal meta-analysis was not performed."
Reasoning: The authors did not perform a meta-analysis.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: No relevant quotes found.
Reasoning: The authors do not present results of any assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: No relevant quotes found.
Reasoning: The authors do not give results of additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: "This systematic review shows laparoscopy to be safe and effective in the treatment of pediatric intussusception" [...] "The laparoscopic approach was successful in more than 70% of cases and the overall complication rate was low (2.9%)."
Reasoning: The authors summarize the main findings and the strength of evidence for each main outcome.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "However, despite the favorable operative and postoperative course demonstrated by these data, we highlight the fact that advanced minimally invasive skills and adequate pediatric laparoscopic equipment are required for laparoscopic resolution of intussusception."
Reasoning: The authors discuss limitations at the study level.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "This systematic review shows laparoscopy to be safe and effective in the treatment of pediatric intussusception" [...] "We advocate for laparoscopy to be considered the primary interventional technique for intussusception in tertiary centers with advanced pediatric minimally invasive skills."
Reasoning: The authors provide a general interpretation of the results and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: No relevant quotes found.
Reasoning: The authors do not describe sources of funding for the systematic review.
Response: [No]

67. Aworanti 2014: Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

LLM response

15 quote(s) from publication full text (mean similarity 100%)

A1. 
Quote: "Here, we reviewed the published treatment options, and their outcomes, for managing RTEF."
Reasoning: The authors state their research question but do not mention a protocol or pre-determined objectives.
Response: [No]

A2. 
Quote: "All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors do not mention the use of two independent data extractors or a consensus procedure for disagreements.
Response: [No]

A3. 
Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula."
Reasoning: The authors mention the databases used and the keywords, but do not provide the years searched or any supplementary search strategies.
Response: [No]

A4. 
Quote: "All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors do not specify whether they included grey literature or unpublished studies in their search.
Response: [No]

A5. 
Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
Reasoning: The authors provide a total number of studies included but do not provide a list of included and excluded studies.
Response: [No]

A6. 
Quote: "A total of 23 papers between 1984 and 2012 described 57 patients undergoing some form of endoscopic treatment (ET) while 21 papers between 1955 and 2013 described 108 patients that underwent an open surgical repair."
Reasoning: The authors provide some characteristics of the included studies but do not provide detailed information on participants, interventions, and outcomes.
Response: [No]

A7. 
Quote: Not available.
Reasoning: The authors do not mention assessing the scientific quality of the included studies.
Response: [No]

A8. 
Quote: Not available.
Reasoning: The authors do not mention using the results of the methodological rigor and scientific quality in formulating their conclusions.
Response: [No]

A9. 
Quote: Not available.
Reasoning: The authors do not mention testing for homogeneity or using a random effects model.
Response: [No]

A10. 
Quote: Not available.
Reasoning: The authors do not mention assessing the likelihood of publication bias.
Response: [No]

A11. 
Quote: Not available.
Reasoning: The authors do not mention potential sources of support for the systematic review or the included studies.
Response: [No]


P1. 
Quote: "Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review"
Reasoning: The title identifies the report as a systematic review.
Response: [Yes]

P2. 
Quote: "Abstract Introduction The management of a recurrent tracheoesophageal fistula (RTEF) includes either open surgery (OS) or an endoscopic treatment (ET); the ideal option is unclear. We aim to comparatively review all published treatment options, and outcomes, for managing RTEF."
Reasoning: The abstract provides a structured summary of the review.
Response: [Yes]

P3. 
Quote: "The spectrum of esophageal atresia (EA) and tracheoesopha- geal fistula (TEF) include an isolated EA, EA with a proximal and/or distal TEF and the “H” or “N” type fistula."
Reasoning: The authors provide a rationale for the review in the context of what is already known.
Response: [Yes]

P4. 
Quote: "Here, we reviewed the published treatment options, and their outcomes, for managing RTEF."
Reasoning: The authors provide an explicit statement of the questions being addressed.
Response: [Yes]

P5. 
Quote: Not available.
Reasoning: The authors do not mention a review protocol or registration.
Response: [No]

P6. 
Quote: "All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
Reasoning: The authors specify the study characteristics used as criteria for eligibility but do not provide a rationale.
Response: [Yes]

P7. 
Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula."
Reasoning: The authors describe the information sources used in the search.
Response: [Yes]

P8. 
Quote: Not available.
Reasoning: The authors do not present a full electronic search strategy for any database.
Response: [No]

P9. 
Quote: Not available.
Reasoning: The authors do not state the process for selecting studies.
Response: [No]

P10. 
Quote: Not available.
Reasoning: The authors do not describe the method of data extraction from reports.
Response: [No]

P11. 
Quote: Not available.
Reasoning: The authors do not list and define all variables for which data were sought.
Response: [No]

P12. 
Quote: Not available.
Reasoning: The authors do not describe the methods used for assessing risk of bias of individual studies.
Response: [No]

P13. 
Quote: Not available.
Reasoning: The authors do not state the principal summary measures.
Response: [No]

P14. 
Quote: Not available.
Reasoning: The authors do not describe the methods of handling data and combining results of studies.
Response: [No]

P15. 
Quote: Not available.
Reasoning: The authors do not specify any assessment of risk of bias that may affect the cumulative evidence.
Response: [No]

P16. 
Quote: Not available.
Reasoning: The authors do not describe methods of additional analyses.
Response: [No]

P17. 
Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
Reasoning: The authors give numbers of studies included in the review but do not provide numbers of studies screened, assessed for eligibility, or reasons for exclusions at each stage.
Response: [No]

P18. 
Quote: "A total of 23 papers between 1984 and 2012 described 57 patients undergoing some form of endoscopic treatment (ET) while 21 papers between 1955 and 2013 described 108 patients that underwent an open surgical repair."
Reasoning: The authors present characteristics for each study but do not provide the citations.
Response: [No]

P19. 
Quote: Not available.
Reasoning: The authors do not present data on risk of bias of each study.
Response: [No]

P20. 
Quote: Not available.
Reasoning: The authors do not present summary data for each intervention group for all outcomes considered.
Response: [No]

P21. 
Quote: Not available.
Reasoning: The authors do not present results of each meta-analysis done.
Response: [No]

P22. 
Quote: Not available.
Reasoning: The authors do not present results of any assessment of risk of bias across studies.
Response: [No]

P23. 
Quote: Not available.
Reasoning: The authors do not give results of additional analyses.
Response: [No]

P24. 
Quote: "In conclusion, based on our findings on 165 published cases, OS for the repair of recurrent TEF has a low morbidity, mortality, and re-fistulation rate particularly when an interposition tissue is placed between the trachea and esophagus."
Reasoning: The authors summarize the main findings of the review.
Response: [Yes]

P25. 
Quote: Not available.
Reasoning: The authors do not discuss limitations at study and outcome level.
Response: [No]

P26. 
Quote: "We recommend OS as the treatment of choice when faced with a recurrent TEF. Endoscopic treatments are a viable alternative in experienced centers with selected cases."
Reasoning: The authors provide a general interpretation of the results in the context of other evidence.
Response: [Yes]

P27. 
Quote: Not available.
Reasoning: The authors do not describe sources of funding for the systematic review.
Response: [No]

68. Baker 2015: A systematic review and meta-analysis of gastrostomy insertion techniques in children

LLM response

30 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "The PRISMA statement, checklist and flowchart were referenced to achieve the highest standard in reporting items for a systematic review and meta-analysis."
- Reasoning: The authors mention using the PRISMA statement, checklist, and flowchart, which suggests that they had a pre-planned methodology.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Screening of eligible studies, data extraction, and assessment of methodological quality were conducted independently by two reviewers."
- Reasoning: The authors mention that two reviewers independently conducted the screening, data extraction, and quality assessment.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "A systematic search of electronic databases was performed to identify all relevant studies comparing two or more gastrostomy insertion techniques in children reporting procedural-related complication rates."
- Reasoning: The authors describe a systematic search of multiple databases for relevant studies.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "Only published data were included in our study."
- Reasoning: The authors explicitly state that only published data were included in the study.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "The search strategy for the review resulted in 22 studies meeting inclusion criteria, with 5346 participants overall."
- Reasoning: The authors mention the number of studies included but do not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Of the 22 studies identified, the median MINORS score of all studies was 14 (range 10–16), max = 24."
- Reasoning: The authors provide some characteristics of the included studies, such as the MINORS score.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of studies and risk of bias."
- Reasoning: The authors mention using the MINORS index to assess the quality of the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "This review suggests that a laparoscopic approach is affiliated with decreased patient morbidity requiring reoperation when compared to an endoscopic gastrostomy insertion approach."
- Reasoning: The authors' conclusions are based on the results of the included studies, which were assessed for quality.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Meta-analysis was preformed for primary and secondary outcomes using RevMan 5.1 (Copenhagen)."
- Reasoning: The authors describe using a meta-analysis to combine the findings of the included studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "Publication bias was evaluated through the generation of a funnel plot of standard error against the log odds ratio."
- Reasoning: The authors mention assessing publication bias using a funnel plot.
- Response: [Yes]

A11. Was the conflict of interest included?
- Quote: Not available.
- Reasoning: The full text does not provide information on potential conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "A systematic review and meta-analysis of gastrostomy insertion techniques in children"
- Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Background: Gastrostomy tubes are inserted via multiple techniques to provide a route for enteral feeding in the pediatric population. This review compares the rate of major complications and resource utilization associated with the various insertion techniques."
- Reasoning: The abstract provides a structured summary of the review, including the background, objectives, methods, results, and conclusions.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Gastrostomy tube placement remains a highly popular intervention with a number of indications, in both adult and pediatric populations. Since initially introduced in 1986 as an open surgical approach, it has evolved into a procedure performed using multiple different techniques by several different operators, including surgeons, gastrointestinal endoscopists and interventional radiologists."
- Reasoning: The introduction provides a rationale for the review in the context of existing knowledge.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "This report evaluates the available literature summarizing complication rates and resource utilization for gastrostomy techniques in children."
- Reasoning: The introduction provides an explicit statement of the research question, including the participants (children), interventions (gastrostomy techniques), and outcomes (complication rates and resource utilization).
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The full text does not provide information on a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "All studies that compared postoperative outcomes in two or more gastrostomy placement techniques in a pediatric population were included. The primary outcome of interest was postoperative complication resulting in death or requiring operative management within one year — our working definition of a major complication."
- Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A systematic search of electronic databases was performed to identify all relevant studies comparing two or more gastrostomy insertion techniques in children reporting procedural-related complication rates."
- Reasoning: The authors describe the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "We used exploded Medical Subject Headings (MeSH) and keywords to search for the following themes: pediatrics, open gastrostomy, percutaneous endoscopic gastrostomy, interventional radiologically guided gastrostomy, and laparoscopic gastrostomy."
- Reasoning: The authors present the search strategy used for the databases.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "All titles and abstracts identified in the electronic database were independently screened for relevance and categorized as relevant, possibly relevant or irrelevant, based on our inclusion criteria."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Data extraction was conducted by 2 reviewers (LB & AB) using a predefined data extraction worksheet."
- Reasoning: The authors describe the data extraction process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The following information was extracted from each article: title, authors, number of centers involved, geographical location, patient demographics, the interventions being compared, complications assessed, markers of resource utilization, as well as the reported findings of the study."
- Reasoning: The authors list the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of studies and risk of bias."
- Reasoning: The authors describe the method used to assess the risk of bias in the included studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Postoperative morbidity necessitating operative management or resulting in mortality was analyzed as dichotomous data, with odds ratios calculated."
- Reasoning: The authors state the principal summary measures used in the review.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Meta-analysis was preformed for primary and secondary outcomes using RevMan 5.1 (Copenhagen)."
- Reasoning: The authors describe the methods used to handle data and combine the results of the included studies.
- Response: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "Publication bias was evaluated through the generation of a funnel plot of standard error against the log odds ratio."
- Reasoning: The authors specify the assessment of publication bias across studies.
- Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The full text does not provide information on additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "The search strategy for the review resulted in 22 studies meeting inclusion criteria, with 5346 participants overall."
- Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included in the review, but do not provide reasons for exclusions at each stage or a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Of the 22 studies identified, the median MINORS score of all studies was 14 (range 10–16), max = 24."
- Reasoning: The authors present some characteristics of the included studies, but do not provide the citations.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "The methodological index for non-randomized studies (MINORS) was utilized to determine the quality of studies and risk of bias."
- Reasoning: The authors present data on the risk of bias of each study.
- Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Studies comparing laparoscopic gastrostomy and PEG revealed a significant increase in major complications with PEG (n = 10 studies, OR 0.29, 95% CI: 0.17–0.51, p b 0.0001)."
- Reasoning: The authors present summary data and effect estimates for each intervention group, along with a forest plot.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Studies comparing laparoscopic gastrostomy and PEG revealed a significant increase in major complications with PEG (n = 10 studies, OR 0.29, 95% CI: 0.17–0.51, p b 0.0001)."
- Reasoning: The authors present the results of the meta-analysis, including confidence intervals.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "Publication bias was evaluated through the generation of a funnel plot of standard error against the log odds ratio."
- Reasoning: The authors present the results of the assessment of publication bias across studies.
- Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The full text does not provide information on additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "This review suggests that a laparoscopic approach is affiliated with decreased patient morbidity requiring reoperation when compared to an endoscopic gastrostomy insertion approach."
- Reasoning: The authors summarize the main findings and their relevance to healthcare providers.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Additional limitations to this review include the retrospective nature of the majority of the studies included."
- Reasoning: The authors discuss the limitations of the review.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "While definitive, ‘level one evidence’ is lacking, these results suggest that any advantages in operative time and resource utilization associated with PEG appear outweighed by the increased safety profile of laparoscopic gastrostomy insertion."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The full text does not provide information on funding sources or other support for the systematic review.
- Response: [No]

69. Berger 2012: Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

LLM response

15 quote(s) from publication full text (mean similarity 98.3%)

A1. Was an 'a priori' design provided?
- Quote: "Methods Systematic review of publications on the topical application of Mitomycin C in children with persistent esophageal stricture."
- Reasoning: The authors mention a systematic review but do not provide a protocol or pre-determined research objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the process of study selection and data extraction.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
- Reasoning: The authors mention a literature search but do not provide details about the databases used, the years covered, or the search strategy.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The text does not mention whether grey literature was included in the search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: No relevant quote found.
- Reasoning: The text does not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "We identified 11 publications including 31 cases."
- Reasoning: The authors mention the number of publications and cases but do not provide detailed characteristics of the included studies.
- Answer: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The text does not mention an assessment of the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the use of the scientific quality of the included studies in formulating conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the methods used to combine the findings of the included studies.
- Answer: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The text does not mention an assessment of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: No relevant quote found.
- Reasoning: The text does not mention conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?"
- Reasoning: The title does not identify the report as a systematic review or meta-analysis.
- Answer: [No]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract Introduction Esophageal strictures refractory to conservative treatment represent a major problem in children. The application of Mitomycin C to the site of stricture has been introduced, but the experience with this novel approach remains very limited. Methods Systematic review of publications on the topical application of Mitomycin C in children with persistent esophageal stricture. Results We identified 11 publications including 31 cases. The underlying cause of stricture was caustic ingestion in 19 (61.2%), esophageal surgery in 7 (22.6%), and others in 5 children (16.2%). The median age of the patients was 48 months (range 4 to 276 months). In the majority of cases cotton pledgets soaked in solution of Mitomycin C were applied endoscopically. Various other techniques such as drug-eluting stents were used. Mitomycin C was applied from 1 to 12 times within intervals from 1 to 12 weeks. The concentrations of Mitomycin C varied considerably between 0.1 and 1 mg/mL. After a mean follow-up time of 22 (6 to 60) months complete relief of symptoms was reported for 21 children (67.7%), and 6 (19.4%) had a partial relief. In four children (12.9%) Mitomycin C treatment failed. No direct or indirect adverse effects were reported. Conclusion The short-term results of topical Mitomycin C application for refractory esophageal stricture reported in the literature are very encouraging. Prospective studies are mandatory to determine the optimal time points, dosage, and modalities of treatment before a recommendation can be given."
- Reasoning: The abstract provides a structured summary including background, objectives, data sources, methods, results, and conclusions. However, it does not mention study eligibility criteria, participants, interventions, study appraisal and synthesis methods, limitations, and implications of key findings.
- Answer: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "For centuries, esophageal strictures have been recognized as an important health problem in children. The etiology includes surgery for malformations of the foregut such as esophageal atresia (EA) and tracheoesophageal fistula (TEF), the ingestion of caustic agents, severe gastroesophageal reflux, and other disease entities."
- Reasoning: The introduction provides a rationale for the review in the context of what is already known.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "In this article, we report the results of a systematic analysis of all published pediatric cases regarding the therapeutic application of Mitomycin C in esophageal stricture and stenosis."
- Reasoning: The introduction provides an explicit statement of the questions being addressed but does not reference participants, interventions, comparisons, outcomes, and study design (PICOS).
- Answer: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The text does not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Inclusion criteria were publications in peer-reviewed journals accessible online via PubMed written in the English, German, or Spanish language. Exclusion criteria were publications on adult patients."
- Reasoning: The authors specify some study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "The current literature was screened for publications regarding the application of Mitomycin C in esophageal stenosis and stricture with special emphasis on pediatric data."
- Reasoning: The authors describe the information sources but do not provide details about the databases used, the dates of coverage, or the date last searched.
- Answer: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: No relevant quote found.
- Reasoning: The text does not present a full electronic search strategy.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: No relevant quote found.
- Reasoning: The text does not state the process for selecting studies.
- Answer: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: No relevant quote found.
- Reasoning: The text does not describe the method of data extraction from reports.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Data were collected on the patient population treated, indication, description of stricture, technique of application, dosage, number of and interval between applications, complications, and outcome."
- Reasoning: The authors list and define the variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The text does not describe methods used for assessing risk of bias of individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: No relevant quote found.
- Reasoning: The text does not state the principal summary measures.
- Answer: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: No relevant quote found.
- Reasoning: The text does not describe the methods of handling data and combining results of studies.
- Answer: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The text does not specify any assessment of risk of bias that may affect the cumulative evidence.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The text does not describe methods of additional analyses.
- Answer: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "We identified 11 publications including 31 cases."
- Reasoning: The authors give the number of studies included in the review but do not provide numbers of studies screened, assessed for eligibility, or excluded, and do not provide a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "We identified 11 publications including 31 cases. The underlying cause of stricture was caustic ingestion in 19 (61.2%), esophageal surgery in 7 (22.6%), and others in 5 children (16.2%). The median age of the patients was 48 months (range 4 to 276 months)."
- Reasoning: The authors present some characteristics for which data were extracted but do not provide the citations.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The text does not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: No relevant quote found.
- Reasoning: The text does not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: No relevant quote found.
- Reasoning: The text does not present results of a meta-analysis.
- Answer: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The text does not present results of an assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The text does not give results of additional analyses.
- Answer: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "The early results of topical Mitomycin C application for the treatment of severe, recurrent esophageal strictures refractory to repeated balloon dilations are encouraging."
- Reasoning: The authors summarize the main findings but do not discuss the strength of evidence for each main outcome or their relevance to key groups.
- Answer: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: No relevant quote found.
- Reasoning: The text does not discuss limitations at the study and outcome level or at the review level.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "The literature reviewed supports the need of larger studies. Questions not yet answered include technical aspects such as the proper and safe way of application, the optimal indication, time point of initial treatment, dosage, as well as the number of applications. All patients who undergo topical application of Mitomycin C for esophageal strictures should be included in long-term follow-up programs."
- Reasoning: The authors provide a general interpretation of the results in the context of other evidence and discuss implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "M. Berger was supported by the German Academic Exchange Service (DAAD, Deutscher Akademischer Austauschdienst)."
- Reasoning: The authors describe a source of funding for the systematic review.
- Answer: [Yes]

70. Billingham 2010: Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis

LLM response

26 quote(s) from publication full text (mean similarity 98.4%)

A1. Was an 'a priori' design provided?
Quotes: "Objectives & The laparoscopic treatment of pediatric populations remains controversial. In order to evaluate the clinical and cost-effectiveness of this surgical approach a number of outcome measures for laparoscopic and open techniques were analyzed in a comparative fashion."
Reasoning: The authors have stated their objectives and the measures they will use to evaluate the studies, but there is no explicit mention of a protocol or pre-determined research objectives.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quotes: None.
Reasoning: The text does not provide information about the process of study selection and data extraction.
Response: [No]

A3. Was a comprehensive literature search performed?
Quotes: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IgentaConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The authors have described a comprehensive literature search across multiple databases.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: None.
Reasoning: The text does not provide information about whether grey literature was included in the search.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: None.
Reasoning: The text does not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "The study design and methodological quality of the included studies are summarized in Table 1."
Reasoning: The authors mention a table summarizing the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "A level of scientific evidence was assigned to each study identified using the set grading criteria outlined by the US Agency for Healthcare Research and Quality [33, 35] : 1: Prospective, randomized comparative trials, 1A: Systematic review or meta-analysis 2: Prospective, non-randomized comparative trials and 3: Retrospective, observational studies. Only level 1, 1A and 2 studies were included in our analyses."
Reasoning: The authors have assessed the scientific quality of the included studies using a grading criteria.
Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias."
Reasoning: The authors have considered the scientific quality of the included studies in formulating their conclusions.
Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Meta-analysis was performed in line with recommendations from the Cochrane Collaboration, the Quality of Reporting of Meta-analyses (QUORUM) and MOOSE initiative guidelines, where appropriate."
Reasoning: The authors have described the methods used to combine the findings of the studies.
Response: [Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: None.
Reasoning: The text does not provide information about the assessment of publication bias.
Response: [No]

A11. Was the conflict of interest included?
Quotes: "Conflict of interest: None"
Reasoning: The authors have stated that there is no conflict of interest.
Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis"
Reasoning: The title identifies the report as a systematic review and meta-analysis.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: "Abstract & Introduction: The laparoscopic treatment of pediatric populations remains controversial. This review was conducted to compare the clinical and cost effectiveness of laparoscopic and open surgical approaches for a variety of surgical indications in pediatric populations. Method/ Design: A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparoscopic and open appendectomy, fundoplication and hernia repair cohorts. Outcomes of interest were length of stay (LOS), operating room (OR) time, complication rates and total hospital costs; aggregation of outcome rates was performed with the Mantel-Haenszel method. Results: A total of 24 articles were identified that met the search and inclusion criteria. LOS was found to be significantly reduced in favor of the laparoscopic approach, with a weighted mean difference of − 1.44 days, although the OR time was significantly increased, with a weighted mean difference of + 12.8 min. Laparoscopic intervention was associated with a significantly reduced complication rate compared to the open approach (10.6 vs. 15.6 % ). Total hospital costs of the laparoscopic approaches were found to be insignificantly increased compared to the open techniques. Conclusion: This review further supports the use of minimally invasive surgery (MIS) in pediatric populations, demonstrating that the three types laparoscopic procedures reviewed resulted in better patient outcomes compared to open procedures, in the form of reduced LOS and overall complication rates. Increased utilization of this approach may prove beneficial to pediatric patients."
Reasoning: The abstract provides a structured summary of the review.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "Introduction & Pediatric surgeons were among the pioneers of laparoscopic surgery in the early 1970s, but the vast potential of this “ minimally invasive ” approach to treat neonates, infants and children with surgical conditions has lagged behind its adult counterpart and has only recently begun to be realized [20] . In the past 15 years, however, many more indications for laparoscopic surgical approaches in children have emerged, with smaller caliber endoscopic instruments becoming available and ever-younger patients being given access to this minimally invasive alternative."
Reasoning: The introduction provides the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "Objectives & The laparoscopic treatment of pediatric populations remains controversial. In order to evaluate the clinical and cost-effectiveness of this surgical approach a number of outcome measures for laparoscopic and open techniques were analyzed in a comparative fashion. These outcome measures included: ▶ Length of stay (LOS) after the procedure, ▶ Operating room (OR) time, ▶ Frequency of postoperative complications and ▶ Total hospital costs."
Reasoning: The objectives section provides an explicit statement of the questions being addressed.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: None.
Reasoning: The text does not provide information about a review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "Assessment of study eligibility Each article was independently assessed for eligibility using the following criteria: Inclusion criteria ▶ Prospective randomized or prospective non-randomized study format only. ▶ Operative results reported for a “ pediatric population ” , using the words “children, infants or neonates” to describe the study group and including infants, neonates or children (or combinations of the three). ▶ Study subjects under 17 years of age only. ▶ Comparison of laparoscopic and open techniques. ▶ Report on at least one of the outcome measures mentioned previously. ▶ Contain a previously unreported patient group (if patient material was reported more than once, the most informative and recent article was chosen). ▶ When 2 studies were reported by the same institution, the analysis included either the one of better quality, or the most recent publication. Exclusion criteria ▶ Studies in which the outcomes of interest were not reported for the 2 techniques or they were impossible to calculate based on the published results. ▶ Studies that used variations on the standard laparoscopic technique (including hybrid procedures, single-trocar technique procedures). ▶ Studies that included conversions from laparoscopy to open surgery in their analyses (unless individual converted subjects were identifiable and could be excluded from the analysis). ▶ Studies that used variations on the standard open technique (including mini-laparotomy procedures). ▶ Studies in which the standard deviation of the mean for continuous outcomes of interest (length of stay and operative time) were not determinable."
Reasoning: The authors have specified the study characteristics and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "To complete this study a comprehensive literature review was conducted. All available electronic databases including the British Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIOSIS Previews, ISI Web of Knowledge, ISI Web of Science and IgentaConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The authors have described all the information sources used in the search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: "The keywords used during the search were: “endoscopic surgery, fundoplication, appendectomy and appendicectomy, inguinal hernia, outcomes, minimally invasive surgery, laparoscopy, endoscopy, laparotomy, open surgery, effectiveness, costs, cost-effectiveness, paediatric and pediatric, infant and neonate” . No limits were used."
Reasoning: The authors have presented the search strategy used, including keywords and the fact that no limits were used.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: "Each article was independently assessed for eligibility using the following criteria: Inclusion criteria ▶ Prospective randomized or prospective non-randomized study format only. ▶ Operative results reported for a “ pediatric population ” , using the words “children, infants or neonates” to describe the study group and including infants, neonates or children (or combinations of the three). ▶ Study subjects under 17 years of age only. ▶ Comparison of laparoscopic and open techniques. ▶ Report on at least one of the outcome measures mentioned previously. ▶ Contain a previously unreported patient group (if patient material was reported more than once, the most informative and recent article was chosen). ▶ When 2 studies were reported by the same institution, the analysis included either the one of better quality, or the most recent publication. Exclusion criteria ▶ Studies in which the outcomes of interest were not reported for the 2 techniques or they were impossible to calculate based on the published results. ▶ Studies that used variations on the standard laparoscopic technique (including hybrid procedures, single-trocar technique procedures). ▶ Studies that included conversions from laparoscopy to open surgery in their analyses (unless individual converted subjects were identifiable and could be excluded from the analysis). ▶ Studies that used variations on the standard open technique (including mini-laparotomy procedures). ▶ Studies in which the standard deviation of the mean for continuous outcomes of interest (length of stay and operative time) were not determinable."
Reasoning: The authors have stated the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: None.
Reasoning: The text does not provide information about the data collection process.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: "These outcome measures included: ▶ Length of stay (LOS) after the procedure, ▶ Operating room (OR) time, ▶ Frequency of postoperative complications and ▶ Total hospital costs."
Reasoning: The authors have listed and defined all variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: "A level of scientific evidence was assigned to each study identified using the set grading criteria outlined by the US Agency for Healthcare Research and Quality [33, 35] : 1: Prospective, randomized comparative trials, 1A: Systematic review or meta-analysis 2: Prospective, non-randomized comparative trials and 3: Retrospective, observational studies. Only level 1, 1A and 2 studies were included in our analyses."
Reasoning: The authors have described the methods used for assessing the risk of bias of individual studies.
Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: "For continuous variables (total hospital costs, LOS and OR time), statistical analysis was carried out using weighted mean differences (WMD) as the summary statistic, comparing the laparoscopic treatment groups with the reference (open surgery) groups using the Mantel-Haenszel method."
Reasoning: The authors have stated the principal summary measures.
Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "Meta-analysis was performed in line with recommendations from the Cochrane Collaboration, the Quality of Reporting of Meta-analyses (QUORUM) and MOOSE initiative guidelines, where appropriate."
Reasoning: The authors have described the methods of handling data and combining results of studies.
Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: None.
Reasoning: The text does not provide information about the assessment of risk of bias across studies.
Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: None.
Reasoning: The text does not provide information about additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "A total of 24 articles were identified that met the search and inclusion criteria. 16 appendectomy, 4 fundoplication and 4 inguinal hernia studies comparing procedural outcomes method were included."
Reasoning: The authors have given the numbers of studies screened, assessed for eligibility, and included in the review.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "The study design and methodological quality of the included studies are summarized in Table 1."
Reasoning: The authors mention a table summarizing the characteristics of the included studies.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: None.
Reasoning: The text does not provide data on the risk of bias of each study.
Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: "A total of 24 articles were identified that met the search and inclusion criteria. LOS was found to be significantly reduced in favor of the laparoscopic approach, with a weighted mean difference of − 1.44 days, although the OR time was significantly increased, with a weighted mean difference of + 12.8 min. Laparoscopic intervention was associated with a significantly reduced complication rate compared to the open approach (10.6 vs. 15.6 % ). Total hospital costs of the laparoscopic approaches were found to be insignificantly increased compared to the open techniques."
Reasoning: The authors have presented summary data for each intervention group and effect estimates.
Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: "Clearly, LOS is significantly reduced in favor of the laparoscopic approach, with an overall weighted mean difference for LOS of − 1.44 days (95 % CI, − 1.89 to − 0.99, p < 0.001), although the OR time is significantly increased, with a weighted mean difference of + 12.8 min (95 % CI, + 3.7 to + 21.9, p = 0.006), favoring the open surgical technique."
Reasoning: The authors have presented the results of the meta-analysis, including confidence intervals.
Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: None.
Reasoning: The text does not provide results of any assessment of risk of bias across studies.
Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: None.
Reasoning: The text does not provide results of additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: "This review strengthens the use of MIS in pediatric populations, demonstrating that the three laparoscopic procedures reviewed showed better patient outcomes compared to open procedures in the form of reduced LOS and complication rates."
Reasoning: The authors have summarized the main findings and considered their relevance to key groups.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias. There may well be an inherent bias in the analyses, which are likely to favor the ‘newer’ MIS/laparoscopic technique. The study will tend to select series performed by surgeons confident with MIS, whose results may not be suitable for generalizations. Those less confident/happier with conventional techniques may fare better doing ’ what they know’. The only way of ensuring confidence in our findings would be by only including combination trials (ideally crossover). Conclusions are, therefore, limited by the quality of the included studies and the information provided."
Reasoning: The authors have discussed the limitations at the study and review level.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "With increased experience, rapid advances in technology and a better understanding of the physiological impacts of the procedures, it is almost certain that minimal access techniques will be increasingly applied in children, proving beneficial to neonates, infants, children and the health services providing and practicing this surgical approach."
Reasoning: The authors have provided a general interpretation of the results and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: None.
Reasoning: The text does not provide information about the sources of funding for the systematic review.
Response: [No]

71. Black 2013: Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

LLM response

23 quote(s) from publication full text (mean similarity 99.9%)

A1. 
Quote: "We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL)."
Reasoning: The authors clearly stated their research question and objectives before conducting the review.
Response: [Yes]

A2. 
Quote: "Two authors independently screened the abstracts and extraction was verified by a second author (JAB and RKS)."
Reasoning: The authors mentioned that two independent reviewers were involved in the study selection and data extraction process.
Response: [Yes]

A3. 
Quote: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched."
Reasoning: The authors performed a comprehensive literature search using multiple databases and supplementary strategies.
Response: [Yes]

A4. 
Quote: "Only papers written in English were retrieved."
Reasoning: The authors did not explicitly state whether they searched for grey literature or unpublished studies.
Response: [No]

A5. 
Quote: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review."
Reasoning: The authors provided a list of included studies but did not provide a list of excluded studies.
Response: [No]

A6. 
Quote: "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance, number of participants, length of follow-up and loss to follow-up."
Reasoning: The authors provided detailed characteristics of the included studies.
Response: [Yes]

A7. 
Quote: "Change in BMI a year after surgery was meta-analysed using a random effects model."
Reasoning: The authors did not provide information on how they assessed the scientific quality of the included studies.
Response: [No]

A8. 
Quote: Not applicable.
Reasoning: The authors did not assess the scientific quality of the included studies, so they could not have used it in formulating their conclusions.
Response: [NA]

A9. 
Quote: "The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
Reasoning: The authors used appropriate methods to combine the findings of the studies and assessed their homogeneity.
Response: [Yes]

A10. 
Quote: Not applicable.
Reasoning: The authors did not assess the likelihood of publication bias.
Response: [NA]

A11. 
Quote: Not applicable.
Reasoning: The authors did not mention any potential sources of support or conflict of interest for the systematic review or the included studies.
Response: [No]


P1. 
Quote: "Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis"
Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
Response: [Yes]

P2. 
Quote: "Summary: The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL)."
Reasoning: The abstract provides a structured summary of the review.
Response: [Yes]

P3. 
Quote: "The global prevalence of obesity is rising in children and adolescents (1)."
Reasoning: The authors described the rationale for the review in the context of what is already known.
Response: [Yes]

P4. 
Quote: "We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL)."
Reasoning: The authors provided an explicit statement of the questions being addressed.
Response: [Yes]

P5. 
Quote: Not applicable.
Reasoning: The authors did not mention a review protocol or registration.
Response: [No]

P6. 
Quote: "Studies were included if (i) they assessed BMI before and a minimum of six months after individuals predominately received AGB, RYGB, BPD or SG and (ii) the mean age of the population was between 6 and 18 years at study entry (18)."
Reasoning: The authors specified the study characteristics used as criteria for eligibility.
Response: [Yes]

P7. 
Quote: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms. Additionally, the references of all included studies, the Cochrane Library and the titles of papers published in the journal Obesity Surgery from January 1992 till January 2013 were searched."
Reasoning: The authors described all information sources in the search.
Response: [Yes]

P8. 
Quote: "The indexed reference libraries EMBASE and Medline were searched between January 1955 and January 2013 using the search terms presented in Table 1, using mapped and exploded terms."
Reasoning: The authors presented the full electronic search strategy for at least one database.
Response: [Yes]

P9. 
Quote: "Two authors independently screened the abstracts and extraction was verified by a second author (JAB and RKS)."
Reasoning: The authors stated the process for selecting studies.
Response: [Yes]

P10. 
Quote: "Two authors independently screened the abstracts and extraction was verified by a second author (JAB and RKS)."
Reasoning: The authors described the method of data extraction from reports.
Response: [Yes]

P11. 
Quote: "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance, number of participants, length of follow-up and loss to follow-up."
Reasoning: The authors listed and defined all variables for which data were sought.
Response: [Yes]

P12. 
Quote: Not applicable.
Reasoning: The authors did not describe methods used for assessing risk of bias of individual studies.
Response: [No]

P13. 
Quote: "Change in BMI a year after surgery was meta-analysed using a random effects model."
Reasoning: The authors stated the principal summary measure.
Response: [Yes]

P14. 
Quote: "The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
Reasoning: The authors described the methods of handling data and combining results of studies.
Response: [Yes]

P15. 
Quote: Not applicable.
Reasoning: The authors did not specify any assessment of risk of bias that may affect the cumulative evidence.
Response: [No]

P16. 
Quote: Not applicable.
Reasoning: The authors did not describe methods of additional analyses.
Response: [No]

P17. 
Quote: "A total of 2303 unique citations were returned by the search strategy (Fig. 1). Of these, 2185 were excluded based on abstract review."
Reasoning: The authors gave numbers of studies screened, assessed for eligibility, and included in the review.
Response: [Yes]

P18. 
Quote: "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance, number of participants, length of follow-up and loss to follow-up."
Reasoning: The authors presented characteristics for which data were extracted for each study.
Response: [Yes]

P19. 
Quote: Not applicable.
Reasoning: The authors did not present data on risk of bias of each study.
Response: [No]

P20. 
Quote: "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI (Table 2)."
Reasoning: The authors presented summary data for each intervention group for all outcomes considered.
Response: [Yes]

P21. 
Quote: "The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
Reasoning: The authors presented results of each meta-analysis done.
Response: [Yes]

P22. 
Quote: Not applicable.
Reasoning: The authors did not present results of any assessment of risk of bias across studies.
Response: [No]

P23. 
Quote: Not applicable.
Reasoning: The authors did not give results of additional analyses.
Response: [No]

P24. 
Quote: "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature."
Reasoning: The authors summarized the main findings including the strength of evidence for each main outcome.
Response: [Yes]

P25. 
Quote: "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature."
Reasoning: The authors discussed limitations at study and outcome level.
Response: [Yes]

P26. 
Quote: "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents."
Reasoning: The authors provided a general interpretation of the results in the context of other evidence, and implications for future research.
Response: [Yes]

P27. 
Quote: Not applicable.
Reasoning: The authors did not describe sources of funding for the systematic review.
Response: [No]

72. Borruto 2010: Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis

LLM response

18 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of our study is to identify clinical evidence on the reliability of the laparoscopic technique compared to the open techniques, with the end points of recurrence rate and hydrocele formation."
- Reasoning: The authors clearly state the research question and inclusion criteria.
- Answer: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention the process of study selection and data extraction.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
- Reasoning: The authors describe the databases used and the time frame for the search, but do not provide keywords or supplementary strategies.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "We recorded 37 studies, but 26 of these were excluded from our analysis using the following criteria: (1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and (2) studies not concerning an adolescent population."
- Reasoning: The authors mention the number of studies included and excluded, but do not provide a list of these studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Eleven studies published between 2000 and 2009 matched the inclusion criteria, comparing varicocele treatments in the pediatric population, and reporting the incidence of complications."
- Reasoning: The authors provide some characteristics of the included studies, but do not provide detailed information such as participant demographics, interventions, and outcomes.
- Answer: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention assessing the quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention the quality of the included studies in their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Because of nonhomogeneous studies, we could not apply the meta-analysis method to all studies simultaneously, but we analyzed different meta-analysis grouping studies with similar features."
- Reasoning: The authors describe their approach to combining the findings of the studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention assessing the likelihood of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any potential conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis"
- Reasoning: The title identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Purpose: Laparoscopic varicocelectomy has gained popularity in recent years. The aim of this study was to identify clinical evidence about the reliability of this technique in the recent literature. Methods: We performed a Medline search for articles published during the last 10 years, using the key words “varicocele,” “treatment,” and “adolescent.” As limits, we used last 10 years, adolescent, clinical trials, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies. The results were investigated in recurrence and hydrocele formation. Results: We pooled 37 studies, but 26 of these were excluded because they were neither relevant nor concerned an adolescent population. Meta-analysis showed that there was no statistical difference between laparoscopic surgery and open surgery in recurrence rate and postoperative hydrocele rate. In the laparoscopic group, the incidence of recurrence was higher in the patients undergoing artery ligation compared to patients undergoing artery and venous ligation. Furthermore, a lower rate of postoperative hydrocele was recorded in patients undergoing dye injections before laparoscopic ligation. Conclusions: Meta-analysis and literature analysis showed that the results after laparoscopic varicocelectomy are comparable to other surgical procedures. The laparoscopic approach has the advantage to treat simultaneously bilateral varicocele."
- Reasoning: The abstract provides a structured summary of the review, including the background, objectives, methods, results, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Varicocele is generally considered the most common correctable cause of male infertility [1,2]. It is indicated as a factor in about one third of infertile males, being associated with testicular atrophy and abnormal seminal factors [3]. Varicocele occurs in 10% to 15% of children and adolescents [4,5]. Several treatment options have been used, including spermatic vein sclerotherapy or embolization, open inguinal ligation of the spermatic vein, subinguinal microscopic varicocelectomy, and, most recently, laparoscopy, but the ideal method for varicocele treatment is still controversial [6-8]."
- Reasoning: The authors provide a rationale for the review in the context of what is already known about varicocele and its treatment.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of our study is to identify clinical evidence on the reliability of the laparoscopic technique compared to the open techniques, with the end points of recurrence rate and hydrocele formation."
- Reasoning: The authors provide an explicit statement of the questions being addressed, including the participants (children and adolescents with varicocele), interventions (laparoscopic vs open techniques), comparisons (reliability of the techniques), and outcomes (recurrence rate and hydrocele formation).
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments. The following key words were used: “varicocele,” “treatment,” and “adolescent.” Searches were also performed using the following as limits: last 10 years, adolescent, clinical trials, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies."
- Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments."
- Reasoning: The authors describe the databases used and the time frame for the search, but do not mention the date of the last search.
- Answer: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "A literature search was performed, using Medline and Pubmed database, on all articles published during the last 10 years (2000-2009), reporting on varicocele treatments. The following key words were used: “varicocele,” “treatment,” and “adolescent.” Searches were also performed using the following as limits: last 10 years, adolescent, clinical trials, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies."
- Reasoning: The authors present the search strategy for the databases used, including the keywords and limits.
- Answer: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "We recorded 37 studies, but 26 of these were excluded from our analysis using the following criteria: (1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and (2) studies not concerning an adolescent population."
- Reasoning: The authors state the process for selecting studies, including the criteria for exclusion.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe the method of data extraction.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Articles with data regarding recurrence, complications (hydrocele, hypotrophy, atrophy), and, if available, semen parameters after treatment were analyzed."
- Reasoning: The authors list the variables for which data were sought, but do not define them or mention any assumptions or simplifications made.
- Answer: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe methods used for assessing risk of bias in individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "The results of continuous variables were reported as mean ± SD, and the statistical difference was calculated using the Student's t test. The statistical difference of percentages was calculated by Pearson's χ2."
- Reasoning: The authors state the principal summary measures used in the review.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Because of nonhomogeneous studies, we could not apply the meta-analysis method to all studies simultaneously, but we analyzed different meta-analysis grouping studies with similar features."
- Reasoning: The authors describe the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors do not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "We recorded 37 studies, but 26 of these were excluded from our analysis using the following criteria: (1) studies that were not relevant, in which outcome of interest were not reported or were impossible to calculate from the results; and (2) studies not concerning an adolescent population."
- Reasoning: The authors give the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, but do not provide a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Eleven studies published between 2000 and 2009 matched the inclusion criteria, comparing varicocele treatments in the pediatric population, and reporting the incidence of complications."
- Reasoning: The authors present some characteristics of the included studies, but do not provide detailed information or citations for each study.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors do not present data on risk of bias within studies.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Eleven studies published between 2000 and 2009 matched the inclusion criteria, comparing varicocele treatments in the pediatric population, and reporting the incidence of complications."
- Reasoning: The authors do not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Meta-analysis showed that there was no statistical difference between laparoscopic surgery and open surgery in recurrence rate and postoperative hydrocele rate."
- Reasoning: The authors present the results of the meta-analysis, but do not provide confidence intervals or measures of consistency.
- Answer: [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "From the analysis performed in our study, results after laparoscopic technique are similar to that after open inguinal approaches (grade A level of evidence 1C). The injection of blue dye before laparoscopic ligation significantly reduces the incidence of hydrocele formation (grade A level of evidence 1C). Ligation of both artery and veins during laparoscopic varicocelectomy significantly reduces the recurrence rate (grade A level of evidence 1C)."
- Reasoning: The authors summarize the main findings and the strength of evidence for each main outcome.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: No relevant quote found.
- Reasoning: The authors do not discuss limitations at the study and outcome level or at the review level.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "From the analysis performed in our study, results after laparoscopic technique are similar to that after open inguinal approaches (grade A level of evidence 1C). The injection of blue dye before laparoscopic ligation significantly reduces the incidence of hydrocele formation (grade A level of evidence 1C). Ligation of both artery and veins during laparoscopic varicocelectomy significantly reduces the recurrence rate (grade A level of evidence 1C)."
- Reasoning: The authors provide a general interpretation of the results in the context of other evidence, but do not discuss implications for future research.
- Answer: [No]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe sources of funding for the systematic review or other support.
- Answer: [No]

73. Castagnetti 2010: Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review

LLM response

17 quote(s) from publication full text (mean similarity 99.7%)

A1. Was an 'a priori' design provided?
- Quote: "A systematic review of the literature was performed in December 2009 according to the criteria of Oxman."
- Reasoning: The authors mention a systematic review but do not provide details about a pre-established protocol or research objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
- Reasoning: The authors mention that three doctors reviewed the abstracts and selected relevant articles by consensus, indicating a duplicate study selection process.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Four databases, MEDLINE/PubMed, EMBASE, Web of Science and the Cochrane Library, were searched using a single term, “hypospadias,” as it defines accurately the subject of this review."
- Reasoning: The authors searched four databases using a single term, indicating a comprehensive literature search.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: No relevant quote found.
- Reasoning: The authors do not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "We included in this review only series containing detailed results after primary repair of severe hypospadias or after curvature correction in patients with primary severe hypospadias."
- Reasoning: The authors provide some information about the characteristics of the included studies, but not in a detailed or aggregated form.
- Answer: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "These studies were generally of low quality (69.5% surgical series). Even the 18 controlled studies were fraught with several methodological flaws, limiting their validity."
- Reasoning: The authors mention assessing the quality of the included studies, but do not provide a detailed assessment for each study.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
- Reasoning: The authors mention the quality of the evidence in their conclusions.
- Answer: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
- Reasoning: The authors did not perform a meta-analysis, so this question is not applicable.
- Answer: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention assessing the likelihood of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any potential conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review"
- Reasoning: The title identifies the report as a systematic review.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: No relevant quote found.
- Reasoning: The abstract is not provided in the text.
- Answer: [NA]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "The aim of the present review was to assess the results of studies published during the last 20 years on the primary repair of severe hypospadias."
- Reasoning: The authors provide a rationale for the review.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of the present review was to assess the results of studies published during the last 20 years on the primary repair of severe hypospadias."
- Reasoning: The authors provide an objective for the review, but do not explicitly address the PICOS components.
- Answer: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "We included in this review only series containing detailed results after primary repair of severe hypospadias or after curvature correction in patients with primary severe hypospadias."
- Reasoning: The authors specify the eligibility criteria for the studies included in the review.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Four databases, MEDLINE/PubMed, EMBASE, Web of Science and the Cochrane Library, were searched using a single term, “hypospadias,” as it defines accurately the subject of this review."
- Reasoning: The authors describe the information sources used in the search.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Four databases, MEDLINE/PubMed, EMBASE, Web of Science and the Cochrane Library, were searched using a single term, “hypospadias,” as it defines accurately the subject of this review."
- Reasoning: The authors present the search strategy, but do not provide enough detail for it to be repeated.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
- Reasoning: The authors describe the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe the data collection process.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: No relevant quote found.
- Reasoning: The authors do not list or define the variables for which data were sought.
- Answer: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "These studies were generally of low quality (69.5% surgical series). Even the 18 controlled studies were fraught with several methodological flaws, limiting their validity."
- Reasoning: The authors mention assessing the quality of the studies, but do not describe the methods used for this assessment.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: No relevant quote found.
- Reasoning: The authors do not state the principal summary measures.
- Answer: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
- Reasoning: The authors did not perform a meta-analysis, so this question is not applicable.
- Answer: [NA]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors do not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "We identified 69 studies for review."
- Reasoning: The authors provide the number of studies included in the review, but do not give numbers of studies screened or assessed for eligibility, nor reasons for exclusions.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: No relevant quote found.
- Reasoning: The authors do not present the characteristics for each study.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors do not present data on risk of bias for each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: No relevant quote found.
- Reasoning: The authors do not present summary data or effect estimates for each study.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Given the low quality and limited validity of the studies available, we did not attempt any meta-analysis."
- Reasoning: The authors did not perform a meta-analysis, so this question is not applicable.
- Answer: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "This systematic review demonstrates the weak evidence supporting current management of primary severe hypospadias."
- Reasoning: The authors summarize the main findings and the strength of the evidence.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "As is expected, this type of review is fraught with methodological imperfections."
- Reasoning: The authors discuss the limitations of their review.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "This systematic review demonstrates the weak evidence supporting current management of primary severe hypospadias."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe the sources of funding for the systematic review.
- Answer: [No]

74. Castagnetti 2016: Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

LLM response

29 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "A systematic review of the literature published after June 1995 was performed in June 2015 in agreement with the PRISMA statement."
- Reasoning: The authors mention that they conducted a systematic review in accordance with the PRISMA statement, but they do not mention a protocol or pre-determined research objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus."
- Reasoning: The authors mention that three doctors independently reviewed the abstracts and selected relevant papers by consensus, indicating a duplicate study selection process.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Three databases, namely, MEDLINE/PubMed, Scopus, and The Cochrane library, were searched for using the free text “hypospadias repair,” in all fields of the records for MEDLINE/PubMed search, and in the Title and Topic fields for the Web of Science and Cochrane library searches."
- Reasoning: The authors describe a comprehensive literature search across three databases using specific keywords.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Of the original 3692 records, 20 (0.6%) studies that matched the criteria for inclusion in the review were finally selected."
- Reasoning: The authors mention the number of studies included in the review, but they do not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Characteristics of included studies are detailed in Table 1."
- Reasoning: The authors provide a table detailing the characteristics of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Papers were categorized according to the Oxford Level of Evidence Working Group 2011 levels of evidence (LOEs) for therapy studies."
- Reasoning: The authors mention that they assessed the quality of the included studies using the Oxford Levels of Evidence.
- Answer: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "Although this review encompasses the best available evidence, some drawbacks should be considered."
- Reasoning: The authors acknowledge the limitations of their review and the quality of the included studies in their conclusions.
- Answer: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Data analysis was subdivided into two parts. First, we performed a cumulative analysis of complications of PR in the reported series. Second, a meta-analysis of case–control and randomized studies comparing PR vs. circumcision was performed."
- Reasoning: The authors describe the methods they used to combine the findings of the included studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "Funnel Plot did not show evidence of significant bias among studies."
- Reasoning: The authors mention that they assessed the likelihood of publication bias using a funnel plot.
- Answer: [Yes]

A11. Was the conflict of interest included?
- Quote: "Conflict of Interest Statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest."
- Reasoning: The authors provide a conflict of interest statement.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Does Preputial reconstruction increase complication rate of hypospadias repair? 20-Year systematic review and Meta-analysis"
- Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "introduction: We performed a systematic review of the literature on preputial reconstruction (PR) during hypospadias repair to determine the cumulative risk of preputial skin complications and the influence of PR on urethroplasty complications, namely, fistula formation and overall reoperation rate of the repair."
- Reasoning: The abstract provides a structured summary of the review, including the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Preputial asymmetry is one of the components of hypospadias. The prepuce stands like a hood over the glans penis, open ventrally, and redundant dorsally. Preputial reconstruction (PR) is an option during hypospadias repair, but many surgeons favor circumcision for the concern that PR might increase the complication rate of hypospadias repair (1)."
- Reasoning: The authors provide a rationale for the review in the context of existing knowledge.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "We performed a systematic review of the literature on PR during hypospadias repair to determine the cumulative risk of specific complications related to the procedure. Moreover, we performed a meta-analysis of studies comparing urethroplasty complications and reoperation rates in patients undergoing hypospadias repair associated with PR vs. circumcision to test the hypothesis that circumcision is associated with a lower rate of complications related to the urethroplasty, namely, fistula rate, and a lower reoperation rate."
- Reasoning: The authors provide an explicit statement of the research questions being addressed, with reference to participants, interventions, comparisons, outcomes, and study design.
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "In the review, we included only studies reporting data on complications of PR (dehiscence of reconstructed prepuce and phimosis), on urethroplasty complications (fistula formation), and on reoperation rates in patients undergoing hypospadias repair with preservation of the prepuce."
- Reasoning: The authors specify the study and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Three databases, namely, MEDLINE/PubMed, Scopus, and The Cochrane library, were searched for using the free text “hypospadias repair,” in all fields of the records for MEDLINE/PubMed search, and in the Title and Topic fields for the Web of Science and Cochrane library searches."
- Reasoning: The authors describe the information sources used in their search.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Three databases, namely, MEDLINE/PubMed, Scopus, and The Cochrane library, were searched for using the free text “hypospadias repair,” in all fields of the records for MEDLINE/PubMed search, and in the Title and Topic fields for the Web of Science and Cochrane library searches. For MEDLINE/PubMed search, “English,” “Humans,” “Males,” and “Publication date from June 1995 to June 2015” were considered, as limits."
- Reasoning: The authors present their full electronic search strategy for multiple databases, including the limits used.
- Answer: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Three doctors reviewed separately the abstracts. Papers relevant to the topic of the review were selected by consensus. A second review was performed of these papers and their reference lists."
- Reasoning: The authors describe the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "For data extraction, dehiscence was considered irrespec- tive of whether partial or complete. Since many reconstructed prepuces are non-retractile soon after surgery, but retractility can spontaneously improve over time, secondary phimosis was defined as a phimosis needing circumcision during follow-up."
- Reasoning: The authors list and define the variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "Papers were categorized according to the Oxford Level of Evidence Working Group 2011 levels of evidence (LOEs) for therapy studies including LOE 1, systematic review of rand- omized trials; LOE 2, randomized trial or observational study with dramatic effect; LOE 3, non-randomized controlled cohort or follow-up study; LOE 4, case series, case–control study, or historically controlled study; or LOE 5, mechanism-based reasoning."
- Reasoning: The authors describe the methods used for assessing the risk of bias of individual studies.
- Answer: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Odds Ratios (OR) and 95% confidence intervals (OR 95% CI) were calculated to determine the influence of PR on the selected outcome."
- Reasoning: The authors state the principal summary measures used in their analysis.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Data analysis was subdivided into two parts. First, we performed a cumulative analysis of complications of PR in the reported series. Second, a meta-analysis of case–control and randomized studies comparing PR vs. circumcision was performed."
- Reasoning: The authors describe the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "Funnel Plot did not show evidence of significant bias among studies."
- Reasoning: The authors specify their assessment of risk of bias across studies.
- Answer: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Of the original 3692 records, 20 (0.6%) studies that matched the criteria for inclusion in the review were finally selected."
- Reasoning: The authors provide the numbers of studies screened, assessed for eligibility, and included in the review, but they do not provide reasons for exclusions at each stage or a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Characteristics of included studies are detailed in Table 1."
- Reasoning: The authors provide a table detailing the characteristics of the included studies.
- Answer: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors do not present data on the risk of bias of each study or any outcome level assessment.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "A meta-analysis of seven studies comparing patients undergoing PR vs. circumcision showed no increased risk of urethral fistula formation associated with PR, odds ratio (OR) (Mantel–Haenszel, Fixed effect, 95% CI), 1.25 (0.80–1.97)."
- Reasoning: The authors present the results of individual studies, including effect estimates and confidence intervals, but they do not provide simple summary data for each intervention group or a forest plot.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "A meta-analysis of seven studies comparing patients undergoing PR vs. circumcision showed no increased risk of urethral fistula formation associated with PR, odds ratio (OR) (Mantel–Haenszel, Fixed effect, 95% CI), 1.25 (0.80–1.97)."
- Reasoning: The authors present the results of their meta-analysis, including confidence intervals.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "Funnel Plot did not show evidence of significant bias among studies."
- Reasoning: The authors present the results of their assessment of risk of bias across studies.
- Answer: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "This systematic review shows that according to available evidence PR carries an 8% risk of specific complications, whereas it does not seem to increase the risk of urethroplasty complications and the overall reoperation rate of hypospadias repairs."
- Reasoning: The authors summarize the main findings of their review and discuss the strength of evidence for each main outcome.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Although this review encompasses the best available evidence, some drawbacks should be considered. Results of systematic reviews are unavoidably dependent on the criteria chosen to select the studies and the quality of the studies included."
- Reasoning: The authors discuss the limitations of their review at the study and review level.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Preputial reconstruction is an option particularly in patients with distal hypospadias without associated penile curvature. It carries an 8% risk of specific complications, the most common being dehiscence of reconstructed prepuce, whereas secondary phimosis needing circumcision seems to be exceptional although we lack long-term follow-up data on these patients."
- Reasoning: The authors provide a general interpretation of the results in the context of other evidence and discuss implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any sources of funding for the systematic review.
- Answer: [No]

75. Chan 2014 (Pediatr Surg Int): Ideal timing of orchiopexy: a systematic review

LLM response

23 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed."
- Reasoning: The authors clearly stated the research question and aim of the study.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs)."
- Reasoning: The authors mentioned that two researchers were involved in the quality assessment of the studies, but it is not clear if they also performed study selection and data extraction.
- Response: [No]

A3. Was a comprehensive literature search performed?
- Quote: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles."
- Reasoning: The authors performed a comprehensive literature search using multiple databases.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not available.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: Not available.
- Reasoning: The authors did not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "We found one relevant systematic review, one RCT, and 30 non-RCTs."
- Reasoning: The authors provided some information about the included studies, but did not provide detailed characteristics of each study.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs)."
- Reasoning: The authors assessed the quality of the included studies using appropriate tools.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "We developed a conclusion based on the highest quality studies."
- Reasoning: The authors used the quality of the studies to inform their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
- Reasoning: The authors did not combine the findings of the studies due to heterogeneity.
- Response: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: Not available.
- Reasoning: The authors did not mention assessing the likelihood of publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: Not available.
- Reasoning: The authors did not mention any conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Ideal timing of orchiopexy: a systematic review"
- Reasoning: The title identifies the report as a systematic review.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract The ideal management of cryptorchidism is a highly debated topic within the field of pediatric surgery. The optimal timing of orchiopexy is particularly unclear, as existing literature reports mixed recommendations. The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed. We conducted a systematic search of MEDLINE, Embase, CINAHL, and the Cochrane Library to find relevant articles. Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs). We developed a conclusion based on the highest quality studies. We found one relevant systematic review, one RCT, and 30 non-RCTs. Fertility potential was greatest when orchiopexy was performed before 1 year of age. Additionally, orchiopexy before 10–11 years may protect against the increased risk of testicular cancer associated with cryptorchidism. Orchiopexy should not be performed before 6 months of age, as testes may descend spontaneously during the first few months of life. The highest quality evidence recommends orchiopexy between 6 and 12 months of age. Surgery during this timeframe may optimize fertility potential and protect against testicular malignancy in children with cryptorchidism."
- Reasoning: The abstract provides a structured summary of the study.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "The ideal management of cryptorchidism is a highly debated topic within the field of pediatric surgery. The optimal timing of orchiopexy is particularly unclear, as existing literature reports mixed recommendations."
- Reasoning: The authors provided a rationale for the review in the context of existing knowledge.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of this study was to determine, based on a systematic review, the most favorable age at which orchiopexy should be performed."
- Reasoning: The authors provided an explicit statement of the research question.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The authors did not mention a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "We included all studies that examined the effect of age at orchiopexy on fertility or malignancy, even if these outcomes were not the primary focus."
- Reasoning: The authors specified the eligibility criteria for the studies.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "We conducted electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 onwards), Embase (1980 onwards), and CINAHL (1982 onwards) to find relevant articles."
- Reasoning: The authors described the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "We used the following search terms: ‘‘Cryptorchidism’’ AND ‘‘Orchiopexy’’ AND ‘‘timing’’ OR ‘‘age’’. We included only English publications and studies pertaining to humans and males. We also excluded any editorials and case reviews."
- Reasoning: The authors presented the search strategy used for the databases.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "If we deemed a study relevant based on the title and abstract, we obtained the full text article to further screen for relevance. Two researchers independently performed each level of screening, comparing the selected studies to reach a consensus. If a consensus could not be reached, they consulted a third researcher."
- Reasoning: The authors described the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "One researcher extracted data from each of the included studies, and a second researcher checked the data for accuracy and completeness."
- Reasoning: The authors described the data extraction process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: Not available.
- Reasoning: The authors did not list and define all variables for which data were sought.
- Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "Two researchers quality assessed each study using the following tools: AMSTAR (systematic reviews), Jadad (RCTs), and MINORS (non-RCTs)."
- Reasoning: The authors described the methods used for assessing the risk of bias in individual studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: Not available.
- Reasoning: The authors did not state the principal summary measures.
- Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
- Reasoning: The authors did not combine the results of the studies due to heterogeneity.
- Response: [NA]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not available.
- Reasoning: The authors did not specify any assessment of risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The authors did not describe any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Our initial search yielded 198 studies. After screening, we quality assessed the 32 remaining studies that met our criteria."
- Reasoning: The authors provided the number of studies screened and included in the review, but did not provide a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "We found one relevant systematic review, one RCT, and 30 non-RCTs."
- Reasoning: The authors provided some information about the included studies, but did not provide detailed characteristics of each study.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not available.
- Reasoning: The authors did not present data on the risk of bias within each study.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "We found one relevant systematic review, one RCT, and 30 non-RCTs. Fertility potential was greatest when orchiopexy was performed before 1 year of age. Additionally, orchiopexy before 10–11 years may protect against the increased risk of testicular cancer associated with cryptorchidism."
- Reasoning: The authors provided a summary of the results of the individual studies, but did not provide effect estimates and confidence intervals for each study.
- Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Due to the heterogeneity of the data, we could not conduct a meta-analysis."
- Reasoning: The authors did not conduct a meta-analysis due to heterogeneity of the data.
- Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not available.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The authors did not conduct any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "In this review, we found that orchiopexy between 6 and 12 months of age may optimize fertility potential and help protect against the increased risk of testicular cancer associated with cryptorchidism."
- Reasoning: The authors summarized the main findings and their relevance.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Our results should be interpreted with caution due to limitations of our study. The most direct measurement of male fertility is paternity rate and time until conception of a live born child; however, due to the difficulty in conducting long-term paternity studies, most research has measured fertility using testicular growth/size, testicular histology at orchiopexy, and semen analysis in adulthood."
- Reasoning: The authors discussed the limitations of their study.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "In this review, we found that orchiopexy between 6 and 12 months of age may optimize fertility potential and help protect against the increased risk of testicular cancer associated with cryptorchidism. Surgery should not be performed before 6 months, as the testis may descend spontaneously during that time."
- Reasoning: The authors provided a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The authors did not mention any sources of funding for the systematic review.
- Response: [No]

76. Chan 2014 (J Pediatr Surg): Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis

LLM response

23 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
Quotes: "Our objective was to compare the outcomes of these procedures in a systematic review and meta-analysis."
Reasoning: The authors stated their objective but did not mention a protocol or pre-determined research objectives.
Response: [No]

A2. Was there duplicate study selection and data extraction?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention the process of study selection and data extraction.
Response: [No]

A3. Was a comprehensive literature search performed?
Quotes: "We sought all publications describing both techniques through MEDLINE, Embase, and CENTRAL."
Reasoning: The authors mentioned the databases used for the literature search.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention whether they included grey literature in their search.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: No relevant quotes found.
Reasoning: The authors did not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: The authors provided a table detailing the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "Two researchers independently assessed each study for methodological quality using MINORS."
Reasoning: The authors used the MINORS tool to assess the quality of the included studies.
Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "Our results should be interpreted with caution owing to the nature of the included studies."
Reasoning: The authors considered the quality of the included studies when formulating their conclusions.
Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "We conducted our meta-analyses using Review Manager 5.2."
Reasoning: The authors used a recognized tool for conducting their meta-analysis.
Response: [Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome."
Reasoning: The authors assessed the likelihood of publication bias using a funnel plot.
Response: [Yes]

A11. Was the conflict of interest included?
Quotes: No relevant quotes found.
Reasoning: The authors did not mention any potential conflicts of interest.
Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis"
Reasoning: The title identifies the report as a meta-analysis.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: The abstract section.
Reasoning: The abstract provides a structured summary of the study.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "Surgery for CDH repair can be performed by the traditional open approach (either laparotomy or thoracotomy), or by minimally invasive surgery (MIS), which has become increasingly popular since the late 1990s [3]."
Reasoning: The authors provided a rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "Thus, our objective was to conduct a systematic review and meta-analysis of all published literature comparing surgical repair techniques for CDH."
Reasoning: The authors provided an explicit statement of the questions being addressed.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: No relevant quotes found.
Reasoning: The authors did not mention a review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "We excluded any studies that did not pertain to humans and children. We also excluded editorials, case reviews, and any studies that did not compare outcomes of MIS with open surgery for Bochdalek-type hernias."
Reasoning: The authors specified the eligibility criteria for the studies.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "To identify all studies comparing MIS with open surgery for CDH repair, we conducted an electronic search of MEDLINE (1966 onwards), Embase (1980 onwards), and the Cochrane Central Register of Controlled Trials (CENTRAL)."
Reasoning: The authors described the information sources used in the search.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: "We used the keywords “diaphragmatic hernia”, “thoracoscopy”, “laparoscopy”, “minimally invasive surgery”, and “open”."
Reasoning: The authors presented the search strategy used for the databases.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: The authors described the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: No relevant quotes found.
Reasoning: The authors did not describe the data collection process.
Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: "Our primary outcome of interest was hernia recurrence after surgery. Secondary outcomes included operative time, total length of stay (LOS), postoperative ventilator time and postoperative mortality."
Reasoning: The authors listed and defined the variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: "Two researchers independently assessed each study for methodological quality using MINORS."
Reasoning: The authors described the methods used for assessing the risk of bias in individual studies.
Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: "We used weighted mean differences to analyze continuous data and odds ratios to analyze categorical variables."
Reasoning: The authors stated the principal summary measures.
Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "For each outcome, we first assessed the heterogeneity of the studies (Chi 2 test and I 2 statistic). When heterogeneity was low to moderate (Q test p N 0.10, I 2 b 50%), we used a fixed-effects model. When heterogeneity was moderate to high (Q test p b 0.10, I 2 N 50%), we used a random-effects model [7]."
Reasoning: The authors described the methods of handling data and combining results of studies.
Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome."
Reasoning: The authors assessed the risk of bias across studies.
Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: "When we conducted a subgroup analysis to examine recurrences within different types of repair (primary and patch repair), we found that the recurrence rate was higher after MIS with patch repair only; for primary repair there was no difference between MIS and open surgery."
Reasoning: The authors described the methods of additional analyses.
Response: [Yes]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "Our initial search of MEDLINE, Embase and CENTRAL yielded 160 studies (Fig. 1). After applying our exclusion criteria, 9 studies remained. We identified one additional relevant study through hand-searching, thus we included 10 studies in total [8–17]."
Reasoning: The authors provided the numbers of studies screened, assessed for eligibility, and included in the review.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "Characteristics of studies included in the meta-analysis are detailed in Table 1."
Reasoning: The authors presented the characteristics of each study.
Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: "Two researchers independently assessed each study for methodological quality using MINORS."
Reasoning: The authors presented data on the risk of bias of each study.
Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: The results section.
Reasoning: The authors presented the results of individual studies.
Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: The results section.
Reasoning: The authors presented the results of the meta-analysis.
Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: "To address the risk of publication bias, we created a funnel plot for the recurrence outcome."
Reasoning: The authors presented the results of the assessment of risk of bias across studies.
Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: "When we conducted a subgroup analysis to examine recurrences within different types of repair (primary and patch repair), we found that the recurrence rate was higher after MIS with patch repair only; for primary repair there was no difference between MIS and open surgery."
Reasoning: The authors presented the results of additional analyses.
Response: [Yes]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: The discussion section.
Reasoning: The authors summarized the main findings and considered their relevance to key groups.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "Our results should be interpreted with caution owing to the nature of the included studies."
Reasoning: The authors discussed the limitations of the study.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "Our results indicate that recurrence of Bochdalek hernia is higher following MIS than open surgery when patch repair is performed."
Reasoning: The authors provided a general interpretation of the results and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: No relevant quotes found.
Reasoning: The authors did not mention any sources of funding for the systematic review.
Response: [No]

77. Chang 2015: Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

LLM response

30 quote(s) from publication full text (mean similarity 99.5%)

A1. Was an 'a priori' design provided?
- Quote: "We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement to report our findings."
- Reasoning: The authors mention using the PRISMA statement, but do not mention a specific protocol or a priori design.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two authors (Hsu and Chang) of the current study independently searched and reviewed the articles. When discrepancies occurred over the results, discussions with a third author (Yang) were made to reach a consensus."
- Reasoning: The authors describe a process of independent study selection and data extraction with a consensus procedure for disagreements.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "We searched PubMed ® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty."
- Reasoning: The authors describe a comprehensive literature search in PubMed, but do not mention searching in at least two databases or using supplementary strategies.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not applicable.
- Reasoning: The authors do not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Figure 1 shows the flowchart of selecting trials."
- Reasoning: The authors provide a flowchart of study selection, but do not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "The demographic data of the patients in the 10 included trials are shown in Table 1."
- Reasoning: The authors provide a table with the characteristics of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Two authors of this paper, Hsu and Chang, evaluated the quality of the study."
- Reasoning: The authors mention assessing the quality of the included studies, but do not provide details on the methods used.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: Not applicable.
- Reasoning: The authors do not discuss the scientific quality of the included studies in relation to their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "All analyses were performed using Review Manager® statistical software (Version 5.3, Cochrane Collaboration, Oxford, England)."
- Reasoning: The authors describe using appropriate statistical software to combine the findings of the studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "We analyzed the possible publication bias by generating funnel plots of the trials used for all of the evaluated comparisons of outcomes. No clear bias was apparent."
- Reasoning: The authors describe assessing the likelihood of publication bias.
- Answer: [Yes]

A11. Was the conflict of interest included?
- Quote: "Acknowledgments The study is partly funded by Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation. TCRD-TPE-103-RT-7."
- Reasoning: The authors acknowledge a source of funding, indicating a potential conflict of interest.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Comparing the efficacy and safety between robotic‑assisted versus open pyeloplasty in children: a systemic review and meta‑analysis"
- Reasoning: The title identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract Objective This manuscript is mainly to systemically review the published reports that compared the efficacy and safety of robotic-assisted (RP) versus open pyeloplasty (OP) in children with ureteropelvic junction obstruction (UPJO)."
- Reasoning: The abstract provides a structured summary of the review.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Open dismembered pyeloplasty remained the best standard treating children with ureteropelvic junction obstruction (UPJO) despite the introduction of minimal invasive therapy."
- Reasoning: The authors provide a rationale for the review in the context of existing knowledge.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "However, its benefits over laparoscopic and open approach were not clearly shown in children. Cundy et al. [22] did a meta-analysis comparing robotic and laparoscopic with open pyeloplasty and concluded that RP is comparable to OP in success rate and complication with borderline significantly less estimated blood loss."
- Reasoning: The authors provide an explicit statement of the questions being addressed.
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not applicable.
- Reasoning: The authors do not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "The following criteria were used to filter studies for our analysis: randomized controlled trials or comparative studies that compared children who received either robotic or open dismembered pyeloplasty for ureteropelvic junction obstruction with data on perioperative parameters, complication rate, and success rate."
- Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "We searched PubMed ® for comparative studies (from January 1990 to 2014 September) that compared the efficacy and safety of robotic versus open pyeloplasty."
- Reasoning: The authors describe the information sources used in the search.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "We used the following keywords: robotic, pyeloplasty, ureteropelvic junction obstruction, children, and pediatric."
- Reasoning: The authors present the search strategy used for the database.
- Answer: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Two authors (Hsu and Chang) of the current study independently searched and reviewed the articles. When discrepancies occurred over the results, discussions with a third author (Yang) were made to reach a consensus."
- Reasoning: The authors describe the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Two authors of this paper, Hsu and Chang, evaluated the quality of the study."
- Reasoning: The authors describe the method of data extraction from reports.
- Answer: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "We extracted the following information from each study: study population characteristics, study design, inclusion and exclusion criteria, operation method, surgical approach, days of hospital stay, complication rate, follow-up period, and assessment of success rate."
- Reasoning: The authors list and define all variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not applicable.
- Reasoning: The authors do not describe methods used for assessing risk of bias of individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "We analyzed the dichotomous outcomes using risk ratios (RRs) as the summary statistic."
- Reasoning: The authors state the principal summary measures.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "All analyses were performed using Review Manager® statistical software (Version 5.3, Cochrane Collaboration, Oxford, England). The meta-analysis was performed using the fixed effect method when there was no statistically significant heterogeneity."
- Reasoning: The authors describe the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "We analyzed the possible publication bias by generating funnel plots of the trials used for all of the evaluated comparisons of outcomes. No clear bias was apparent."
- Reasoning: The authors specify an assessment of risk of bias that may affect the cumulative evidence.
- Answer: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not applicable.
- Reasoning: The authors do not describe methods of additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Figure 1 shows the flowchart of selecting trials. Initial research yielded 104 abstracts, and a total of 102 abstracts were included for evaluation after duplicates were removed."
- Reasoning: The authors provide a flow diagram and give numbers of studies screened, assessed for eligibility, and included in the review.
- Answer: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "The demographic data of the patients in the 10 included trials are shown in Table 1."
- Reasoning: The authors present characteristics for each study and provide the citations.
- Answer: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not applicable.
- Reasoning: The authors do not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Fig. 2 Forest plot of comparison: robotic-assisted versus open pyeloplasty. Outcome: (A) age, (B) operative time, (C) hospital stay, (D) costs"
- Reasoning: The authors present simple summary data for each intervention group and effect estimates and confidence intervals with a forest plot.
- Answer: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Pooled analysis revealed a significant heterogeneity (p = 0.001), and patients underwent RP were borderline significantly older than OP (WMD = 3.58 years, 95 CI −0.29 to 7.46, p = 0.07) due to a paucity of studies that reported mean age with a standard deviation (Fig. 2a)."
- Reasoning: The authors present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "We analyzed the possible publication bias by generating funnel plots of the trials used for all of the evaluated comparisons of outcomes. No clear bias was apparent."
- Reasoning: The authors present results of an assessment of risk of bias across studies.
- Answer: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not applicable.
- Reasoning: The authors do not give results of additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "The current meta-analysis fails to validate robotic pyeloplasty as a standard of care in managing pediatric UPJO in the current status."
- Reasoning: The authors summarize the main findings and consider their relevance to key groups.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "There were several limitations to this study. First, the included studies were all retrospective in origin with lack of prospective data."
- Reasoning: The authors discuss limitations at the study and review level.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "We urge the pediatric laparoendoscopists and manufacturer to improve the surgical efficacy and safety of pediatric robotic-assisted pyeloplasty."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "Acknowledgments The study is partly funded by Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation. TCRD-TPE-103-RT-7."
- Reasoning: The authors describe sources of funding for the systematic review.
- Answer: [Yes]

78. Chen 2013: Transanal endorectal pull-through versus transabdominal approach for Hirschsprung’s disease: A systematic review and meta-analysis

LLM response

24 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
- Reasoning: The authors stated that they performed a comprehensive meta-analysis, but they did not mention a protocol or pre-determined research objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database."
- Reasoning: The authors mentioned that three reviewers independently appraised each study and extracted data.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.” The reference lists of the full articles were also manually searched to identify additional eligible studies."
- Reasoning: The authors described a comprehensive search strategy using multiple databases and manual search of reference lists.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: No relevant quote found.
- Reasoning: The authors did not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Our study included 792 patients; 444 underwent TERPT and 348 underwent TAB (including 215 Soave from eight studies, 94 Duhamel from five studies, 24 Swenson from two studies and 15 Rehbein procedures from one study)."
- Reasoning: The authors provided some characteristics of the included studies, such as the number of patients and the types of procedures performed.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any assessment of the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention the scientific quality of the included studies in their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
- Reasoning: The authors described the methods used to combine the findings of the studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any assessment of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis"
- Reasoning: The title identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach (TAB) are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB. Methods: Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis. Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables. Results: Of 93 studies, 1 RCT and 11 OCS were included, comprising 444 cases of TERPT and 348 cases of TAB (215 Soave, 94 Duhamel, 24 Swenson, 15 Rehbein procedures). TERPT had shorter operative time (MD = −57.85 min; 95% confidence interval [CI], −83.11 to − 32.60; P b 0.00001) and hospital stay (MD = −7.06 days; 95% CI, −10.95 to −3.16; P = 0.0004). TERPT had less postoperative incontinence/ soiling (OR = 0.58; 95% CI 0.37–0.90; P = 0.01) and constipation (OR = 0.49; 95% CI 0.30–0.81; P = 0.005). There was no difference in incidence of postoperative enterocolitis. Conclusion: TERPT is superior to TAB in operative time, hospital stay, postoperative incontinence and constipation. However, more randomized controlled trials are necessary to verify the benefit of TERPT for Hirschsprung's disease."
- Reasoning: The abstract provides a structured summary of the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Since the first description of aganglionosis in the myenteric plexus of the distal colon in congenital megacolon by Dalla Valle et al., a variety of surgical procedures have been described in an attempt to restore normal bowel function in Hirschsprung's disease (HD) [1–6]. For many years, surgical treatment of HD involved staged procedures; an initial diverting enterostomy was followed by definitive transabdominal pull-through surgery with subsequent closure of the colostomy. These multi-stage surgeries have gradually been replaced by the primary pull-through surgery in many centers [7]."
- Reasoning: The authors provided a rationale for the review in the context of what is already known about the surgical treatment of Hirschsprung's disease.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "To compare the clinical outcomes of TERPT and TAB, we performed a systematic review and comprehensive meta-analysis from indexed published literature."
- Reasoning: The authors provided an explicit statement of the questions being addressed, although they did not explicitly mention the PICOS components.
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors did not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "All studies comparing the functional outcome of TERPT with TAB were considered to meet the inclusion criteria and full articles were retrieved. Because of the paucity of available randomized control trials (RCT) addressing the study question, observational clinical studies (OCS) were also included."
- Reasoning: The authors specified the study characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.” The reference lists of the full articles were also manually searched to identify additional eligible studies."
- Reasoning: The authors described the information sources used in the search and the date last searched.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.”"
- Reasoning: The authors presented the search strategy for multiple databases, but did not provide enough detail for it to be repeated.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "After identifying relevant titles and abstracts, the studies were assessed for eligibility for inclusion in our meta-analysis. All studies comparing the functional outcome of TERPT with TAB were considered to meet the inclusion criteria and full articles were retrieved."
- Reasoning: The authors described the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database."
- Reasoning: The authors described the method of data extraction from reports.
- Answer: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The following data were evaluated: patient's age at operation, length of aganglionic segment, operative time, length of hospital stay, duration of follow-up and the incidence of postoperative incontinence, constipation and enterocolitis."
- Reasoning: The authors listed and defined all variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe methods used for assessing risk of bias of individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables."
- Reasoning: The authors stated the principal summary measures.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables using the Mantel–Haenszel method. Pooled mean differences (MD) were measured for continuous variables using the inverse variance method in meta-analysis."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors did not specify any assessment of risk of bias that may affect the cumulative evidence.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe methods of additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Of 93 studies, 1 RCT and 11 OCS were included, comprising 444 cases of TERPT and 348 cases of TAB (215 Soave, 94 Duhamel, 24 Swenson, 15 Rehbein procedures)."
- Reasoning: The authors gave numbers of studies screened, assessed for eligibility, and included in the review, but did not provide reasons for exclusions at each stage or a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Our study included 792 patients; 444 underwent TERPT and 348 underwent TAB (including 215 Soave from eight studies, 94 Duhamel from five studies, 24 Swenson from two studies and 15 Rehbein procedures from one study)."
- Reasoning: The authors presented characteristics for each study, but did not provide the citations.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors did not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Of 93 studies, 1 RCT and 11 OCS were included, comprising 444 cases of TERPT and 348 cases of TAB (215 Soave, 94 Duhamel, 24 Swenson, 15 Rehbein procedures). TERPT had shorter operative time (MD = −57.85 min; 95% confidence interval [CI], −83.11 to − 32.60; P b 0.00001) and hospital stay (MD = −7.06 days; 95% CI, −10.95 to −3.16; P = 0.0004). TERPT had less postoperative incontinence/ soiling (OR = 0.58; 95% CI 0.37–0.90; P = 0.01) and constipation (OR = 0.49; 95% CI 0.30–0.81; P = 0.005). There was no difference in incidence of postoperative enterocolitis."
- Reasoning: The authors presented simple summary data for each intervention group and effect estimates and confidence intervals, but did not provide a forest plot.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "TERPT had shorter operative time (MD = −57.85 min; 95% confidence interval [CI], −83.11 to − 32.60; P b 0.00001) and hospital stay (MD = −7.06 days; 95% CI, −10.95 to −3.16; P = 0.0004). TERPT had less postoperative incontinence/ soiling (OR = 0.58; 95% CI 0.37–0.90; P = 0.01) and constipation (OR = 0.49; 95% CI 0.30–0.81; P = 0.005). There was no difference in incidence of postoperative enterocolitis."
- Reasoning: The authors presented results of each meta-analysis done, including confidence intervals.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors did not give results of additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Our meta-analysis suggests that the TERPT is superior to the conventional TAB pull-through for Hirschsprung's disease."
- Reasoning: The authors summarized the main findings and considered their relevance to healthcare providers.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Our results appear to favor TERPT for most postoperative outcomes. However, this result must be interpreted cautiously due to the limitations of this study. The lack of randomized trials is a key problem."
- Reasoning: The authors discussed limitations at the study and review level.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "In conclusion, compared to TAB, TERPT is associated with shorter operative time, hospital stay and lesser postoperative incontinence and constipation. However, the lack of large prospective studies of robust design cannot be trivialized. More randomized controlled trials are necessary to verify the benefit of TERPT for Hirschsprung's disease. Longer follow-up is also needed to determine bowel function and quality of life in patients who undergo TERPT."
- Reasoning: The authors provided a general interpretation of the results in the context of other evidence, and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe sources of funding for the systematic review.
- Answer: [No]

79. Corbett 2015: Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review

LLM response

22 quote(s) from publication full text (mean similarity 99.2%)

2 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. Was an 'a priori' design provided?
- Quote: "The study aimed to systematically analyse published literature to give an overall success rate for endopyelotomy in children."
- Reasoning: The authors state their research question and aim, but there is no explicit mention of a protocol or pre-determined research objectives.
- Response: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "The inclusion of publications was decided by both the study authors and data were extracted independently by both study authors."
- Reasoning: The authors mention that both of them were involved in the study selection and data extraction process.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Medline and Embase databases were searched using relevant key search terms."
- Reasoning: The authors mention the databases used and the key terms for the search, but they do not mention any supplementary strategies.
- Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "One hundred and fourteen studies were assessed, 15 were included in the final review."
- Reasoning: The authors mention the number of studies assessed and included, but they do not provide a list of these studies or the excluded ones.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Fifteen studies published between 1987 and 2012 are included in the review."
- Reasoning: The authors mention the number and the publication years of the included studies, but they do not provide detailed characteristics of these studies.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any assessment of the scientific quality of the included studies.
- Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention the scientific quality of the included studies in their conclusions.
- Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "The median success rate was 71% (range 46e100) in the primary group and 75% (range 25e100) in the secondary group."
- Reasoning: The authors mention how they combined the findings of the studies, but they do not discuss any assessment of homogeneity or the appropriateness of combining the studies.
- Response: [No]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention any assessment of publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of interest: None. Funding: None."
- Reasoning: The authors clearly state that there is no conflict of interest or funding source.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review"
- Reasoning: The title clearly identifies the report as a systematic review.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Summary: Introduction" [...] "Study design" [...] "Objective" [...] "Results" [...] "Discussion" [...] ""
- Reasoning: The abstract provides a structured summary of the review, including the background, objectives, data sources, results, and discussion.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Dismembered pyeloplasty is the gold standard treatment for pelviureteric obstruction (PUJO) although endourological techniques are also employed. Outcomes and success rates for paediatric endopyelotomy are variably reported."
- Reasoning: The authors provide a rationale for the review in the context of existing knowledge.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The study aimed to systematically analyse published literature to give an overall success rate for endopyelotomy in children."
- Reasoning: The authors state the objective of the review, but they do not explicitly mention the PICOS components.
- Response: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration information.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Literature reviews, individual case reports, exclusively adult studies (age >20 years), and small case series of fewer than three paediatric patients were excluded."
- Reasoning: The authors specify some of the eligibility criteria for the studies included in the review.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Medline and Embase databases were searched using relevant key search terms."
- Reasoning: The authors mention the databases used for the search, but they do not provide the dates of coverage or the date of the last search.
- Response: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Medline and Embase databases were searched using relevant key search terms."
- Reasoning: The authors mention the databases and key search terms used, but they do not provide a full electronic search strategy.
- Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "All retrieved studies were evaluated by reading the abstracts, and full papers were retrieved for articles that could not be rejected based on abstract alone."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "The inclusion of publications was decided by both the study authors and data were extracted independently by both study authors."
- Reasoning: The authors describe the data extraction process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: No relevant quote found.
- Reasoning: The authors do not list or define the variables for which data were sought.
- Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe any methods for assessing the risk of bias in the included studies.
- Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "The median success rate was 71% (range 46e100) in the primary group and 75% (range 25e100) in the secondary group."
- Reasoning: The authors state the principal summary measure used in the review.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe the methods of handling data and combining results of studies.
- Response: [No]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors do not specify any assessment of risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "The initial search retrieved 242 titles. Once duplicate records had been excluded (n Z 128), 114 titles were assessed for eligibility."
- Reasoning: The authors provide numbers of studies screened and assessed for eligibility, but they do not provide reasons for exclusions at each stage or a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Fifteen studies published between 1987 and 2012 are included in the review."
- Reasoning: The authors mention the number and the publication years of the included studies, but they do not provide detailed characteristics or citations for these studies.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors do not present data on the risk of bias within studies.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "The median success rate was 71% (range 46e100) in the primary group and 75% (range 25e100) in the secondary group."
- Reasoning: The authors present summary data for each group, but they do not provide effect estimates and confidence intervals for individual studies.
- Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: No relevant quote found.
- Reasoning: This is a systematic review without a meta-analysis, so this item is not applicable.
- Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "The study found success rates of 71% for primary endopyelotomy and 75% for secondary procedures, neither of which compare favourably with established outcome data for open and laparoscopic pyeloplasty."
- Reasoning: The authors summarize the main findings of the review.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Finally, the limitations of this review must be born in mind. The review includes reports that cover a wide time period during which both diagnostic modalities and operative techniques have evolved."
- Reasoning: The authors discuss the limitations of the review.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Crossing vessels are a significant concern in children with primary PUJO and should be excluded before considering endopyelotomy. Furthermore, due consideration must be given to the greater costs and complication rates associated with the procedure."
- Reasoning: The authors provide a general interpretation of the results and discuss the implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "Funding: None."
- Reasoning: The authors clearly state that there was no funding for the review.
- Response: [Yes]

80. Cullis 2016: Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

LLM response

28 quote(s) from publication full text (mean similarity 97.2%)

A1. Was an 'a priori' design provided?
- Quote: "In light of uncertainty and controversy, we undertook a systematic review of the available literature to determine (1) whether screening of IRA is obligatory in ‘‘asymptomatic’’ patients with heterotaxy and (2) whether detection of a rotational anomaly war-rant(s) surgical correction in such a fragile patient cohort."
- Reasoning: The authors clearly state the research question and inclusion criteria before conducting the review.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two reviewers (P.S.C., S.S.) performed the study selection, data extraction, and quality assessment processes independently and all data was recorded in tabular form electronically. Disagreements were resolved by discussion or consultation with the third reviewer/senior corresponding author who conceived the study (P.D.L.)."
- Reasoning: The authors describe a process of independent study selection and data extraction by two reviewers, with a third reviewer resolving disagreements.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928). The search was conducted using the indexed databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated on June 18, 2015). Additional articles were identified through the reference listings of those articles yielded through the initial electronic database search."
- Reasoning: The authors describe a comprehensive search strategy using multiple databases, keywords, and reference lists.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "Conference proceedings and unpublished data were screened additionally."
- Reasoning: The authors mention that they included grey literature in their search.
- Response: [Yes]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Nineteen studies were included for systematic review."
- Reasoning: The authors mention the number of studies included but do not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Table 2 summarizes the main characteristics of the 19 included studies."
- Reasoning: The authors provide a table summarizing the characteristics of the included studies.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria."
- Reasoning: The authors describe the use of a quality assessment tool (MINORS) to evaluate the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "As all studies identified were retrospective analyses, the Methodological Index for Non-randomized Studies (MINORS) was employed to assess methodological quality."
- Reasoning: The authors mention that they considered the quality of the studies when formulating their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "All studies were retrospective case series (meta-analysis was therefore not formally undertaken other than cumulative totals and percentages of data included)."
- Reasoning: The authors did not perform a meta-analysis, but they did combine the findings of the studies in a descriptive manner.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: Not applicable.
- Reasoning: The authors do not mention assessing for publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "No funding was sought or received for this work."
- Reasoning: The authors disclose that they did not receive any funding for the review, which could be a potential source of conflict of interest.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary? A Systematic Review in Search of the Evidence"
- Reasoning: The title clearly identifies the report as a systematic review.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: Not applicable.
- Reasoning: The abstract is not included in the provided text.
- Response: [NA]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Heterotaxy is an abnormal arrangement of thoraco-abdominal viscera across a left-to-right axis. Intestinal rotational anomalies are frequent among patients with heterotaxy, but debate exists as to whether they are benign in nature, requiring careful observation alone, or if surgical correction is warranted to prevent obstruction or midgut volvulus."
- Reasoning: The authors provide a rationale for the review based on the existing debate in the literature.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "In light of uncertainty and controversy, we undertook a systematic review of the available literature to determine (1) whether screening of IRA is obligatory in ‘‘asymptomatic’’ patients with heterotaxy and (2) whether detection of a rotational anomaly war-rant(s) surgical correction in such a fragile patient cohort."
- Reasoning: The authors clearly state the objectives of the review.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: "The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A local review protocol was established."
- Reasoning: The authors mention a review protocol but do not provide information on where it can be accessed or any registration information.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Eligibility criteria were then applied to remaining studies (Table 1)."
- Reasoning: The authors specify the eligibility criteria for the studies included in the review.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928). The search was conducted using the indexed databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated on June 18, 2015). Additional articles were identified through the reference listings of those articles yielded through the initial electronic database search."
- Reasoning: The authors describe the information sources used in the search, including databases and reference lists, and provide the dates of the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http:// links.lww.com/SLA/A928)."
- Reasoning: The authors mention a keyword algorithm but do not provide the full search strategy for any database.
- Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Two reviewers (P.S.C., S.S.) performed the study selection, data extraction, and quality assessment processes independently and all data was recorded in tabular form electronically. Disagreements were resolved by discussion or consultation with the third reviewer/senior corresponding author who conceived the study (P.D.L.)."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Two reviewers (P.S.C., S.S.) performed the study selection, data extraction, and quality assessment processes independently and all data was recorded in tabular form electronically. Disagreements were resolved by discussion or consultation with the third reviewer/senior corresponding author who conceived the study (P.D.L.)."
- Reasoning: The authors describe the data extraction process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The primary outcome evaluated was mortality associated with conservative or surgical management of IRA. Secondary outcomes included development of malrotation with obstruction or midgut volvulus, that is, symptomatic IRA and complications thereof with surgical intervention."
- Reasoning: The authors list and define the primary and secondary outcomes for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria."
- Reasoning: The authors describe the use of the MINORS criteria to assess the risk of bias in the included studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "All studies were retrospective case series (meta-analysis was therefore not formally undertaken other than cumulative totals and percentages of data included)."
- Reasoning: The authors state that they used cumulative totals and percentages as summary measures.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "All studies were retrospective case series (meta-analysis was therefore not formally undertaken other than cumulative totals and percentages of data included)."
- Reasoning: The authors describe how they handled and combined the data from the included studies.
- Response: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not applicable.
- Reasoning: The authors do not mention assessing for risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not applicable.
- Reasoning: The authors do not mention conducting any additional analyses.
- Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Six hundred seventy-three citations were retrieved through the full literature search, of which there were 226 duplicates. Nineteen studies were included for systematic review."
- Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included in the review, but they do not provide reasons for exclusions at each stage or a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Table 2 summarizes the main characteristics of the 19 included studies."
- Reasoning: The authors provide a table summarizing the characteristics of the included studies.
- Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria."
- Reasoning: The authors mention assessing the risk of bias within studies using the MINORS criteria, but they do not present the data on risk of bias for each study.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "These 9 studies included a cumulative total of 414 patients managed expectantly, that is, ‘‘asymptomatic patients’’ in whom no IRA screening was undertaken (group A), 191 cases in whom screening was performed routinely (group B), and 92 patients who were considered ‘‘symptomatic’’ of potential rotational anomalies and therefore underwent imaging or laparotomy (group C)."
- Reasoning: The authors present summary data for each group of patients in the included studies, but they do not provide effect estimates and confidence intervals for each study.
- Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: Not applicable.
- Reasoning: The authors did not perform a meta-analysis.
- Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not applicable.
- Reasoning: The authors do not mention assessing for risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not applicable.
- Reasoning: The authors do not mention conducting any additional analyses.
- Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "This systematic review shows that ‘‘asymptomatic patients’’ with heterotaxy are at a low risk of developing IRA-related complications. Of 414 patients managed expectantly, only a single patient (0.24%) developed symptoms directly attributable to IRA during the total follow-up period."
- Reasoning: The authors summarize the main findings of the review and discuss their relevance.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "We fully acknowledge that there are some limitations with the present study. Follow-up reporting data in studies we analyzed was sometimes poor. This may influence long-term outcome(s) of both a ‘‘watchful waiting’’ policy and operative intervention. Adequate reporting in studies was thus by no means always satisfactory."
- Reasoning: The authors discuss the limitations of the review, including issues with follow-up reporting data and the quality of reporting in the included studies.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Given the fragility of this patient cohort—with cardiac comorbidity(s)—many can therefore avoid an unnecessary Ladd’s operation."
- Reasoning: The authors provide a general interpretation of the results and discuss their implications.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "No funding was sought or received for this work."
- Reasoning: The authors disclose that they did not receive any funding for the review.
- Response: [Yes]

81. Cundy 2014 (BJU Int): Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children

LLM response

26 quote(s) from publication full text (mean similarity 98.9%)

A1. Was an 'a priori' design provided?
Quotes: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003969) and analysis was performed in accordance with recommendations outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement [5]."
Reasoning: The authors mention that the study protocol was registered on the PROSPERO database, indicating an 'a priori' design.
Response: [Yes]

A2. Was there duplicate study selection and data extraction?
Quotes: "Two authors independently undertook literature searches, screened abstracts, and assessed eligible articles against inclusion criteria (T.P.C., A.H.H.). There was 90% agreement on identification of articles and discrepancies were resolved by consensus, or arbitrated by a third author (E.K.M.)."
Reasoning: The authors mention that two authors independently conducted the literature search and data extraction, and any disagreements were resolved by consensus or a third author.
Response: [Yes]

A3. Was a comprehensive literature search performed?
Quotes: "Systematic literature searches were undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Ovid Medline and EMBASE electronic databases using the following search strategy using the following Medical Subject Headings (MeSH): (‘Surgery, Computer-Assisted’ OR ‘robotics’ OR ‘da Vinci’ OR ‘telerobotic’ OR ‘telesurgery’ OR ‘robotic surgery’) AND (‘Pediatrics’ OR ‘Infant’ OR ‘Child’ OR ‘Adolescent’) AND (‘Kidney’ OR ‘Pelvi-ureteric Junction Obstruction’ OR ‘Pyeloplasty’). The search was conducted up to December 2013. The primary search was supplemented with searches of: i) PubMed related articles feature, ii) clinicaltrials.gov registry using the keyword ‘pyeloplasty’, and iii) abstracts of the International Pediatric Endosurgery Group Annual Congresses (2002–2013), the AUA Annual Meetings (2006–2013), Section of Urology Program of the American Association of Pediatrics National Conference (2007–2012), and World Congress of Endourology (2008–2013)."
Reasoning: The authors performed a comprehensive literature search using multiple databases and supplementary strategies.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not mention whether they included grey literature in their search.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
Quotes: "In all, 12 observational studies met inclusion criteria, reporting outcomes of 384 RAP, 131 LP, and 164 OP procedures. No randomised controlled trials were identified."
Reasoning: The authors provide some information about the characteristics of the included studies, but not in a detailed or aggregated form.
Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total out of 15) [6]."
Reasoning: The authors mention that they assessed the quality of the included studies using the Newcastle-Ottawa Scale.
Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
Quotes: "The median (range) mNOS score was 9 (4–14) (Table 4)."
Reasoning: The authors mention the quality scores of the included studies, but do not explicitly state how these scores were used in formulating their conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
Quotes: "Statistical analysis was conducted using Review Manager ® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
Reasoning: The authors describe the statistical methods used to combine the findings of the included studies.
Response: [Yes]

A10. Was the likelihood of publication bias assessed?
Quotes: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
Reasoning: The authors mention that they assessed the likelihood of publication bias using funnel plots and statistical tests.
Response: [Yes]

A11. Was the conflict of interest included?
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not mention any conflicts of interest for the systematic review or the included studies.
Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
Quotes: "Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children"
Reasoning: The title identifies the report as a meta-analysis.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
Quotes: The abstract provides a structured summary including background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings, and systematic review registration number.
Reasoning: The abstract includes all the necessary components of a structured summary.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
Quotes: "Pyeloplasty is the most prevalently reported and highest volume application of robot-assisted minimally invasive surgery in children [1]. There is now an abundance of case reports and case series that clearly show the safety and feasibility of robot-assisted pyeloplasty (RAP) in paediatric populations [1]."
Reasoning: The authors provide a rationale for the review in the context of existing knowledge.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
Quotes: "The aim of the present study was therefore to undertake a meta-analysis of RAP vs LP and OP in children."
Reasoning: The authors provide an explicit statement of the questions being addressed, referencing participants, interventions, comparisons, and outcomes.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
Quotes: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003969) and analysis was performed in accordance with recommendations outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement [5]."
Reasoning: The authors mention that the review protocol was registered on the PROSPERO database and provide the registration number.
Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
Quotes: "All included studies satisfied the following criteria: i) comparing RAP vs LP and/or OP; ii) involving paediatric patients with mean study group ages of <18 years; iii) reporting five or more patients in each study group; iv) involving singular pathologies or procedures; and v) investigating objective clinical outcome measures or cost. No language restrictions were imposed. In the event of duplication of data, more recent studies or those with larger sample sizes were preferentially considered."
Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
Quotes: "Systematic literature searches were undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Ovid Medline and EMBASE electronic databases using the following search strategy using the following Medical Subject Headings (MeSH): (‘Surgery, Computer-Assisted’ OR ‘robotics’ OR ‘da Vinci’ OR ‘telerobotic’ OR ‘telesurgery’ OR ‘robotic surgery’) AND (‘Pediatrics’ OR ‘Infant’ OR ‘Child’ OR ‘Adolescent’) AND (‘Kidney’ OR ‘Pelvi-ureteric Junction Obstruction’ OR ‘Pyeloplasty’). The search was conducted up to December 2013. The primary search was supplemented with searches of: i) PubMed related articles feature, ii) clinicaltrials.gov registry using the keyword ‘pyeloplasty’, and iii) abstracts of the International Pediatric Endosurgery Group Annual Congresses (2002–2013), the AUA Annual Meetings (2006–2013), Section of Urology Program of the American Association of Pediatrics National Conference (2007–2012), and World Congress of Endourology (2008–2013)."
Reasoning: The authors describe all the information sources used in the search and the date the search was last conducted.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
Quotes: "Systematic literature searches were undertaken of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Ovid Medline and EMBASE electronic databases using the following search strategy using the following Medical Subject Headings (MeSH): (‘Surgery, Computer-Assisted’ OR ‘robotics’ OR ‘da Vinci’ OR ‘telerobotic’ OR ‘telesurgery’ OR ‘robotic surgery’) AND (‘Pediatrics’ OR ‘Infant’ OR ‘Child’ OR ‘Adolescent’) AND (‘Kidney’ OR ‘Pelvi-ureteric Junction Obstruction’ OR ‘Pyeloplasty’). The search was conducted up to December 2013."
Reasoning: The authors present the full electronic search strategy for multiple databases.
Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
Quotes: "Two authors independently undertook literature searches, screened abstracts, and assessed eligible articles against inclusion criteria (T.P.C., A.H.H.). There was 90% agreement on identification of articles and discrepancies were resolved by consensus, or arbitrated by a third author (E.K.M.)."
Reasoning: The authors describe the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
Quotes: "Two authors independently undertook literature searches, screened abstracts, and assessed eligible articles against inclusion criteria (T.P.C., A.H.H.). There was 90% agreement on identification of articles and discrepancies were resolved by consensus, or arbitrated by a third author (E.K.M.)."
Reasoning: The authors describe the method of data extraction from reports.
Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
Quotes: "Primary outcomes of interest were operative success, requirement for re-operation, conversion rates, postoperative complications, and urinary leakage complication rates. Secondary outcome measures were estimated blood loss (EBL), length of hospital stay (LOS), operating time (OT), analgesia requirement, and cost."
Reasoning: The authors list and define all variables for which data were sought.
Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
Quotes: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total out of 15) [6]."
Reasoning: The authors describe the methods used for assessing the risk of bias in individual studies.
Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
Quotes: "A weighted random-effects model was used for all analyses. Pooled odds ratios (ORs) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables. Both ORs and WMDs are reported with 95% CIs."
Reasoning: The authors state the principal summary measures used in the review.
Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
Quotes: "Statistical analysis was conducted using Review Manager ® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
Reasoning: The authors describe the methods of handling data and combining results of studies.
Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
Quotes: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
Reasoning: The authors specify the assessment of risk of bias that may affect the cumulative evidence.
Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not mention any additional analyses.
Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
Quotes: "In all, 12 observational studies met inclusion criteria, reporting outcomes of 384 RAP, 131 LP, and 164 OP procedures. No randomised controlled trials were identified."
Reasoning: The authors give the numbers of studies screened, assessed for eligibility, and included in the review, but do not provide reasons for exclusions at each stage or a flow diagram.
Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
Quotes: "In all, 12 observational studies met inclusion criteria, reporting outcomes of 384 RAP, 131 LP, and 164 OP procedures. No randomised controlled trials were identified."
Reasoning: The authors present some characteristics for each study, but do not provide the citations.
Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
Quotes: "The median (range) mNOS score was 9 (4–14) (Table 4)."
Reasoning: The authors present data on the risk of bias of each study.
Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
Quotes: The authors present simple summary data for each intervention group, effect estimates and confidence intervals, and forest plots for all outcomes considered.
Reasoning: The authors present the results of individual studies for all outcomes considered.
Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
Quotes: The authors present the results of each meta-analysis done, including confidence intervals and measures of consistency.
Reasoning: The authors present the synthesis of results for each meta-analysis done.
Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
Quotes: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
Reasoning: The authors present the results of the assessment of risk of bias across studies.
Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not mention any additional analyses.
Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
Quotes: "Meta-analysis of the current literature identifies no significant differences between RAP and LP or OP for the five primary outcome variables assessed. Significant differences in favour of RAP were found for secondary outcome variables of EBL (vs OP) and LOS (vs LP and OP). OT was found to be significantly longer for RAP vs OP. Limited evidence from observational studies indicates lower opiate analgesia requirement for RAP (vs LP and OP), higher total costs for RAP vs OP, and comparable costs for RAP vs LP."
Reasoning: The authors summarize the main findings and the strength of evidence for each main outcome.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
Quotes: "No randomised controlled trials were identified. Unfortunately, this is not unusual despite these trials being considered the ‘gold-standard’ method of comparative assessment [27]. A distinct absence of prospective studies was also identified. The reliance upon less robust retrospective data are inadequate and represents a major weakness in the current literature base for paediatric robot-assisted surgery [1]."
Reasoning: The authors discuss the limitations at the study and review level.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
Quotes: "There is a strong need for higher quality evidence in the form of prospective observational studies and clinical trials, as well as further cost-effectiveness analyses."
Reasoning: The authors provide a general interpretation of the results and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
Quotes: No specific quotes related to this criterion.
Reasoning: The authors do not mention any sources of funding for the systematic review.
Response: [No]

82. Cundy 2014 (J Pediatr Surg): Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children

LLM response

32 quote(s) from publication full text (mean similarity 98.7%)

A1. Was an 'a priori' design provided?
- Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
- Reasoning: The authors registered their study protocol on a recognized database.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM)."
- Reasoning: The authors used a duplicate process for study selection and data extraction.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases" [...] "The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword “fundoplication”, and 3) abstracts of the International Pediatric Endosurgery Group annual congress from 2002 to 2013."
- Reasoning: The authors searched two databases and used supplementary search strategies.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No specific quote available.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Six studies met inclusion criteria, involving 135 robot-assisted and 162 conventional laparoscopic fundoplication procedures."
- Reasoning: The authors mentioned the number of studies included but did not provide a list of excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages b 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
- Reasoning: The authors provided the characteristics of the included studies.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total/15)."
- Reasoning: The authors assessed the quality of the included studies using a recognized tool.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
- Reasoning: The authors considered the quality of the included studies when formulating their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
- Reasoning: The authors used appropriate statistical methods to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors assessed the likelihood of publication bias using recognized methods.
- Response: [Yes]

A11. Was the conflict of interest included?
- Quote: No specific quote available.
- Reasoning: The authors did not mention any conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
- Reasoning: The title identifies the report as a meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: The abstract provides a structured summary including background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings, and systematic review registration number.
- Reasoning: The abstract includes all the necessary components.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "The role of robotic surgery in this setting remains unclear, generating a growing sentiment of polarized opinion amongst the surgical community, which is without a well-defined evidence base. The aim of this study is to critically appraise the literature comparing robot-assisted versus conventional laparoscopic MIS for fundoplication in order to further elucidate the comparative safety and efficacy of these techniques."
- Reasoning: The authors provided a rationale for the review in the context of what is already known.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
- Reasoning: The authors provided an explicit statement of the questions being addressed.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
- Reasoning: The authors indicated that a review protocol exists and provided registration information.
- Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages b 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
- Reasoning: The authors specified the study characteristics and report characteristics used as criteria for eligibility.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases" [...] "The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword “fundoplication”, and 3) abstracts of the International Pediatric Endosurgery Group annual congress from 2002 to 2013."
- Reasoning: The authors described all the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy (“Surgery, Computer-Assisted”[MeSH] OR “robotics“[MeSH] OR “da Vinci” OR “telerobotic” OR “telesurgery” OR “robotic surgery”) AND (“Pediatrics”[MeSH] OR “Infant”[MeSH] OR “Child”[MeSH] OR “Adolescent” [MeSH]) AND (“Fundoplication”[MeSH] OR “Gastroesophageal reflux”[MeSH]). The search period was defined as June 2001 to June 2013 inclusively."
- Reasoning: The authors presented a full electronic search strategy for two databases.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by consensus and discussion with the senior author (AD)."
- Reasoning: The authors stated the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by consensus and discussion with the senior author (AD)."
- Reasoning: The authors described the method of data extraction from reports.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Primary outcome measures of interest were intra-operative conversions, intra-operative complications, length of hospital stay (LOS), post-operative complications, operating time (OT), analgesia requirement and cost."
- Reasoning: The authors listed and defined all variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total/15)."
- Reasoning: The authors described the methods used for assessing the risk of bias in individual studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables. Both OR and WMD are reported with 95% confidence intervals (CI)."
- Reasoning: The authors stated the principal summary measures.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors specified an assessment of risk of bias that may affect the cumulative evidence.
- Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: "In evaluating breakdown of operative times for defined procedural stages, Lehnert et al. found initial time from skin incision to start of hiatal region dissection to be significantly longer in the RF group (P = 0.002) [14]. Inversely, they also found that for the more technically difficult aspect of the procedure, hiatal dissection was significantly shorter in the RF group (P = 0.005) [14]."
- Reasoning: The authors described methods of additional analyses.
- Response: [Yes]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Six studies met inclusion criteria, involving 135 robot-assisted and 162 conventional laparoscopic fundoplication procedures."
- Reasoning: The authors gave the numbers of studies screened, assessed for eligibility, and included in the review.
- Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Six observational studies met inclusion criteria, reporting outcomes of 297 children. No randomized controlled trials were identified."
- Reasoning: The authors presented the characteristics for each study.
- Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "The median mNOS score was 8 (range 5–14, Table 3)."
- Reasoning: The authors presented data on the risk of bias of each study.
- Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Pooled analysis determined no statistically significant differences between RF and LF for conversions, OT, LOS, and post-operative complications."
- Reasoning: The authors presented simple summary data for each intervention group and effect estimates and confidence intervals.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Pooled analysis determined no statistically significant differences between RF and LF for conversions, OT, LOS, and post-operative complications."
- Reasoning: The authors presented the results of each meta-analysis done, including confidence intervals and measures of consistency.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors presented the results of an assessment of risk of bias across studies.
- Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: "In evaluating breakdown of operative times for defined procedural stages, Lehnert et al. found initial time from skin incision to start of hiatal region dissection to be significantly longer in the RF group (P = 0.002) [14]. Inversely, they also found that for the more technically difficult aspect of the procedure, hiatal dissection was significantly shorter in the RF group (P = 0.005) [14]."
- Reasoning: The authors gave the results of additional analyses.
- Response: [Yes]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children."
- Reasoning: The authors summarized the main findings including the strength of evidence for each main outcome.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
- Reasoning: The authors discussed the limitations at the study and outcome level.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Higher quality and longer-follow up studies are now required to more definitively and comprehensively determine the role of robotic-assisted techniques in this setting. Equipoise in short-term clinical outcomes emphasizes the need for further cost-effectiveness analysis to also be undertaken."
- Reasoning: The authors provided a general interpretation of the results in the context of other evidence, and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No specific quote available.
- Reasoning: The authors did not mention any sources of funding for the systematic review.
- Response: [No]

83. Cundy 2014 (Eur J Pediatr Surg): Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

LLM response

32 quote(s) from publication full text (mean similarity 99.3%)

A1. Was an 'a priori' design provided?
- Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
- Reasoning: The authors mention that the study protocol was registered on the PROSPERO database.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM)."
- Reasoning: The authors mention that two authors independently conducted the literature search and data extraction.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy" [...] ""
- Reasoning: The authors describe a comprehensive search strategy using multiple databases.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "The primary search was supplemented with searches of 1) PubMed related articles feature, 2) clinicaltrials.gov registry using the keyword “fundoplication”, and 3) abstracts of the International Pediatric Endosurgery Group annual congress from 2002 to 2013."
- Reasoning: The authors mention searching clinical trial registries and conference abstracts, which are considered grey literature.
- Response: [Yes]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Six studies met inclusion criteria, involving 135 robot-assisted and 162 conventional laparoscopic fundoplication procedures."
- Reasoning: The authors mention the number of studies included but do not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages b 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
- Reasoning: The authors provide the characteristics of the included studies.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total/15)."
- Reasoning: The authors mention using the Newcastle-Ottawa Scale to assess the quality of the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
- Reasoning: The authors acknowledge the limitations of the included studies in their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
- Reasoning: The authors describe the statistical methods used to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors mention assessing the risk of publication bias using funnel plots and statistical tests.
- Response: [Yes]

A11. Was the conflict of interest included?
- Quote: Not available.
- Reasoning: The full text provided does not include information on conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children"
- Reasoning: The title identifies the report as a meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Background: Minimally invasive fundoplication may be performed using either a robot-assisted (RF) or conventional laparoscopic (LF) technique. Evidence comparing RF and LF in children remains unclear. This study aims to elucidate the comparative safety and efficacy of RF versus LF by systematic review and meta-analysis."
- Reasoning: The abstract provides a structured summary of the study.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "The role of robotic surgery in this setting remains unclear, generating a growing sentiment of polarized opinion amongst the surgical community, which is without a well-defined evidence base."
- Reasoning: The authors describe the rationale for the review in the context of the current state of knowledge.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of this study is to critically appraise the literature comparing robot-assisted versus conventional laparoscopic MIS for fundoplication in order to further elucidate the comparative safety and efficacy of these techniques."
- Reasoning: The authors provide an explicit statement of the research question being addressed.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: "The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42013003971)."
- Reasoning: The authors mention that the review protocol was registered on the PROSPERO database.
- Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "All included studies satisfied the following criteria: 1) comparing robot-assisted (RF) versus conventional laparoscopic fundoplication (LF), 2) involving pediatric patients with mean or median study group ages b 18 years, 3) reporting ≥ 5 patients in each study group, and 4) investigating either objective clinical outcome measures or GERD symptoms via standardized questionnaires."
- Reasoning: The authors specify the eligibility criteria for the studies included in the review.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy" [...] "The search period was defined as June 2001 to June 2013 inclusively."
- Reasoning: The authors describe the information sources and the search period.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Systematic literature searches were undertaken of PubMed and EMBASE electronic databases using the following search strategy (“Surgery, Computer-Assisted”[MeSH] OR “robotics“[MeSH] OR “da Vinci” OR “telerobotic” OR “telesurgery” OR “robotic surgery”) AND (“Pediatrics”[MeSH] OR “Infant”[MeSH] OR “Child”[MeSH] OR “Adolescent” [MeSH]) AND (“Fundoplication”[MeSH] OR “Gastroesophageal reflux”[MeSH])."
- Reasoning: The authors present the full electronic search strategy for the databases used.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by consensus and discussion with the senior author (AD)."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Two authors independently undertook literature searches, screened abstracts and assessed articles against eligibility criteria (TPC, HJM). Discrepancies were resolved by consensus and discussion with the senior author (AD)."
- Reasoning: The authors describe the data collection process.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Primary outcome measures of interest were intra-operative conversions, intra-operative complications, length of hospital stay (LOS), post-operative complications, operating time (OT), analgesia requirement and cost."
- Reasoning: The authors list and define the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "The methodological quality of studies was appraised using a star-based modified Newcastle-Ottawa Scale (mNOS) that considers patient selection, inter-group comparability, and outcome assessment (maximum 3, 10, and 2 stars respectively; total/15)."
- Reasoning: The authors describe the method used to assess the risk of bias in the individual studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables."
- Reasoning: The authors state the principal summary measures used in the review.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Statistical analysis was conducted using Review Manager® Version 5.1.7 for Windows (The Cochrane Collaboration, Software Update, Oxford, UK) and STATA v.11 statistical analysis software (StataCorp LP, TX, USA). A weighted random-effects model was used for all analyses."
- Reasoning: The authors describe the methods used to handle data and combine the results of the studies.
- Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors specify the assessment of risk of bias across studies.
- Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The full text provided does not include information on additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Six studies met inclusion criteria, involving 135 robot-assisted and 162 conventional laparoscopic fundoplication procedures."
- Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included in the review, but do not provide reasons for exclusions at each stage or a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Six observational studies met inclusion criteria, reporting outcomes of 297 children. No randomized controlled trials were identified."
- Reasoning: The authors present the characteristics of the included studies.
- Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "The median mNOS score was 8 (range 5–14, Table 3)."
- Reasoning: The authors present data on the risk of bias within each study.
- Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Pooled analysis determined no statistically significant differences between RF and LF for conversions, OT, LOS, and post-operative complications."
- Reasoning: The authors present the results of individual studies for all outcomes considered.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Pooled odds ratios (OR) were calculated as the summary statistic for dichotomous variables and weighted mean difference (WMD) calculated for continuous variables."
- Reasoning: The authors present the results of the meta-analysis, including confidence intervals and measures of consistency.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "Risk of publication bias was assessed by visual inspection of funnel plots in addition to statistical estimation with both Begg and Mazumdar’s test and Egger’s test for small study effects."
- Reasoning: The authors present the results of the assessment of risk of bias across studies.
- Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The full text provided does not include information on additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Meta-analysis of the current literature identifies comparable safety and short-term efficacy for robot-assisted laparoscopic fundoplication when compared to conventional laparoscopic fundoplication in children."
- Reasoning: The authors summarize the main findings and the strength of evidence for each main outcome.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "The majority of comparative effectiveness literature is comprised of small retrospective studies with historical controls. The strength of this meta-analysis is therefore limited by inherent vulnerability of these study designs to multiple sources of bias and both known and unknown confounders."
- Reasoning: The authors discuss the limitations of the study.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Higher quality and longer-follow up studies are now required to more definitively and comprehensively determine the role of robotic-assisted techniques in this setting. Equipoise in short-term clinical outcomes emphasizes the need for further cost-effectiveness analysis to also be undertaken."
- Reasoning: The authors provide a general interpretation of the results and discuss the implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The full text provided does not include information on funding.
- Response: [No]

84. Ding 2013: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis

LLM response

33 quote(s) from publication full text (mean similarity 98.4%)

A1. Was an 'a priori' design provided?
- Quote: "Therefore, the authors collected all studies published since 1992 that compared SILA versus TILA to perform a meta-analysis and investigated the safety and efficacy of two approaches in the treatment of appendicitis."
- Reasoning: The authors state that they planned to perform a meta-analysis comparing SILA and TILA, but they do not mention a protocol or pre-determined objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database."
- Reasoning: The authors mention that three researchers were involved in data extraction, but they do not specify if this was done independently or if there was a consensus process for disagreements.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012."
- Reasoning: The authors describe their search strategy and the databases they used, but they do not mention any supplementary strategies.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention searching for grey literature or including/excluding studies based on their publication status.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "According to the search strategy and inclusion criteria, a total of 17 studies [5,15–30] that included 1809 appendicectomy cases (793 SILA and 1016 TILA) were considered suitable for meta-analysis."
- Reasoning: The authors mention the number of studies included in their meta-analysis and provide references, but they do not provide a list of excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
- Reasoning: The authors provide a table with the characteristics of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "We used a star scoring system [12] based on criteria related to study design, comparability of patient groups, and outcome assessment to assess literature quality."
- Reasoning: The authors describe their method for assessing the quality of the included studies.
- Answer: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "Most of the studies included in our meta-analysis were retrospective studies, which could have led to some selection bias."
- Reasoning: The authors acknowledge the limitations of their study, including the quality of the included studies.
- Answer: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Statistically, it was not possible to combine the analysis of mean and median, and only data in the form of means and standard deviation were included in the meta-analysis."
- Reasoning: The authors describe their method for combining the findings of the included studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident."
- Reasoning: The authors assess the likelihood of publication bias using a funnel plot.
- Answer: [Yes]

A11. Was the conflict of interest included?
- Quote: "This study was supported by Science and Technology Fund of Guizhou Province. Grant Number: 黔科合J字 [2008]2181."
- Reasoning: The authors disclose the source of funding for their study, but they do not mention any conflicts of interest for the included studies.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis"
- Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Background: This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis. Materials and Methods: Studies published since 1992 that compared SILA versus TILA in laparoscopic appendicectomy were collected. Data on operative parameters, postoperative recovery, postoperative pain and complications, and hospitalization costs for SILA and TILA were meta-analyzed using fixed-effect and random-effect models. Results: Seventeen studies (1 randomized controlled trial and 16 retrospective studies) that included 1809 patients were studied. Of these patients, 793 and 1016 had undergone SILA and TILA, respectively. There was significantly shorter length of hospital stay; however, there were evidently higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs for SILA compared with TILA. Other outcome variables such as operative time, blood loss, time to first oral intake, postoperative pain and complications were not found to be statistically significant for either group. Conclusions: Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed."
- Reasoning: The abstract provides a structured summary of the background, objectives, methods, results, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Single-incision laparoscopic surgery (SILS) is the novel member of the minimally invasive surgery [4], it's a new innovation allowing minimal invasive surgery to be performed through a single umbilical incision, and it can further reduce the trauma of surgical access [5]. SILS has made great strides forward in general surgery, urological and gynecological surgery in recent years [6–11], its treatment for appendicitis (i.e. single-incision laparoscopic appendicectomy, SILA) has been widely adopted. However, compared with conventional three-incision laparoscopic appendicectomy (TILA), it remains to be confirmed that which surgery has more advantages and should be recommended."
- Reasoning: The authors provide a rationale for their review in the context of the current state of knowledge.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "Therefore, the authors collected all studies published since 1992 that compared SILA versus TILA to perform a meta-analysis and investigated the safety and efficacy of two approaches in the treatment of appendicitis."
- Reasoning: The authors clearly state the objectives of their review, including the participants (patients with appendicitis), interventions (SILA and TILA), comparisons (between SILA and TILA), and outcomes (safety and efficacy).
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Inclusion criteria were: (1) clinical studies that compared single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis between 1992 and 2012; (2) patients with primary appendicitis; and (3) raw data included some of the following: operative parameters, postoperative recovery, postoperative complications, postoperative pain and hospital charges. Exclusion criteria were: (1) no three-incision laparoscopic appendectomy as a control; (2) secondary appendicitis; (3) duplicate publication or the publication did not provide sufficient data."
- Reasoning: The authors specify the eligibility criteria for the studies included in their review.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012."
- Reasoning: The authors describe the databases they used for their search and the time period covered.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The search strategy was as follows: (single-port or single-incision or single-access or single-site or single or one) AND (laparoscopic or laparoscopy or minimal invasive surgery) AND (appendectomy or appendix)."
- Reasoning: The authors provide their search strategy, which could be repeated.
- Answer: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database."
- Reasoning: The authors describe the process for selecting studies, but they do not provide details about the screening and eligibility assessment.
- Answer: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Three researchers extracted data from each study by using a structured sheet and entered the data into a database."
- Reasoning: The authors describe their data extraction process, but they do not mention any processes for obtaining and confirming data from investigators.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters, postoperative recovery, postoperative complications, postoperative pain and hospital charges."
- Reasoning: The authors list the variables for which they sought data.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "We used a star scoring system [12] based on criteria related to study design, comparability of patient groups, and outcome assessment to assess literature quality."
- Reasoning: The authors describe their method for assessing the risk of bias in the included studies.
- Answer: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "In this meta-analysis, weighted mean differences (WMD) were used for the analysis of continuous variables, and odds ratios (OR) were used for dichotomous variables."
- Reasoning: The authors state the summary measures they used in their meta-analysis.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Random-effect models were used to identify heterogeneity between the studies [13]. Heterogeneity was assessed using the χ2 test."
- Reasoning: The authors describe their methods for handling data and combining the results of the included studies.
- Answer: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident."
- Reasoning: The authors assess the risk of publication bias across the included studies.
- Answer: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: "Seven outcomes were selected for sensitivity analysis. The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]."
- Reasoning: The authors describe their methods for additional analyses, including sensitivity analysis.
- Answer: [Yes]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "According to the search strategy and inclusion criteria, a total of 17 studies [5,15–30] that included 1809 appendicectomy cases (793 SILA and 1016 TILA) were considered suitable for meta-analysis."
- Reasoning: The authors provide the number of studies screened, assessed for eligibility, and included in the review, but they do not provide reasons for exclusions at each stage or a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1."
- Reasoning: The authors present the characteristics of the included studies and provide citations.
- Answer: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: "Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29]."
- Reasoning: The authors present data on the risk of bias within each study.
- Answer: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "The meta-analysis revealed no significant differences in operative time and blood loss between SILA and TILA."
- Reasoning: The authors present summary data and effect estimates for each outcome, but they do not provide this information for each individual study or use a forest plot.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "In the pooled data, there were no significant differences in operative time between SILA and TILA (WMD: 0.91; 95% CI:−2.58 to 4.41; P = 0.61) (Fig. 2A)."
- Reasoning: The authors present the results of their meta-analysis, including confidence intervals.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident."
- Reasoning: The authors present the results of their assessment of risk of bias across studies.
- Answer: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: "Seven outcomes were selected for sensitivity analysis. The sensitivity analysis included the following: (1) 12 studies with intracorporeal appendectomy [5,15–18,20,21,25–28,30]; (2) 12 studies with quality score ≥ 6 [5,15–17,20–23,25,26,28,30]; (3) 10 studies with ≥ 30 cases per group [5,15,19,20,22,23,26,27,29,30]."
- Reasoning: The authors present the results of their additional analyses, including sensitivity analysis.
- Answer: [Yes]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "In conclusion, this study suggests that SILA is a safe technical alternative to TILA for patients with appendicitis. It involves significantly shorter hospital stay and possible improvement in cosmesis [22], and comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA."
- Reasoning: The authors summarize their main findings and discuss their relevance.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "We have identified some limitations of this meta-analysis. Firstly, the differences in the age of included patients, pathological type of appendicitis and instruments of SILS may affect the comparability of the included studies. Secondly, different studies may have had different defining criteria for the outcomes we were interested in, which may not be reported in the study methodology."
- Reasoning: The authors discuss the limitations of their review.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Therefore, more well-designed, multicenter, prospective randomized controlled trials are expected to be published to allow for a more convincing evaluation."
- Reasoning: The authors provide a general interpretation of their results and discuss the implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "This study was supported by Science and Technology Fund of Guizhou Province. Grant Number: 黔科合J字 [2008]2181."
- Reasoning: The authors disclose the source of funding for their review.
- Answer: [Yes]

85. Dingemann 2014: Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?

LLM response

14 quote(s) from publication full text (mean similarity 99.7%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of our study was to present a current analysis of the highest available evidence concerning pediatric VATS."
- Reasoning: The authors stated their research question and aim of the study.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: Not available.
- Reasoning: The authors did not mention the process of study selection and data extraction.
- Response: [No]

A3. Was a comprehensive literature search performed?
- Quote: "Clinical studies published in the English literature were identified by a Medline literature search using PubMed (www. pubmed.com). The Web site was last accessed on January 2, 2013."
- Reasoning: The authors mentioned the database used for the literature search but did not provide details about the search strategy.
- Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not available.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: Not available.
- Reasoning: The authors did not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "A total of 21 manuscripts met the inclusion criteria of our systematic review of which 3 were MA and 18 were RCS."
- Reasoning: The authors provided some information about the included studies, but did not provide detailed characteristics.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Levels of evidence were determined using the recent CEBM criteria."
- Reasoning: The authors mentioned that they assessed the quality of the included studies using the CEBM criteria.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3."
- Reasoning: The authors considered the quality of the included studies in their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: Not available.
- Reasoning: The authors did not perform a meta-analysis, so this item is not applicable.
- Response: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: Not available.
- Reasoning: The authors did not mention assessing the likelihood of publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of Interest: None."
- Reasoning: The authors declared that they had no conflicts of interest.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?"
- Reasoning: The title indicates that this is a review of evidence.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Introduction Video-assisted thoracoscopic surgery (VATS) has gained enormous acceptance among pediatric surgeons. However, most studies on advantages of VATS do not reach a high level of evidence. According to a recent classification of the Oxford Centre for Evidence-Based Medicine (CEBM), studies can be classified into Levels 1 to 5 in order of descending quality. We aimed to identify comparative studies investigating VATS versus open procedures in pediatric surgery and to classify publications according to the CEBM criteria."
- Reasoning: The abstract provides a structured summary of the study.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "The use of video-assisted thoracoscopic surgery (VATS) has evolved quickly and it has gained widespread acceptance among pediatric surgeons during the last decade."
- Reasoning: The authors provided a rationale for the review in the context of what is already known.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of our study was to present a current analysis of the highest available evidence concerning pediatric VATS."
- Reasoning: The authors stated the objective of the review.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The authors did not mention a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Clinical studies published in the English literature were identified by a Medline literature search using PubMed (www. pubmed.com). The Web site was last accessed on January 2, 2013."
- Reasoning: The authors specified the eligibility criteria for the studies.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Clinical studies published in the English literature were identified by a Medline literature search using PubMed (www. pubmed.com). The Web site was last accessed on January 2, 2013."
- Reasoning: The authors described the information sources and the date of the last search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: Not available.
- Reasoning: The authors did not present a full electronic search strategy.
- Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: Not available.
- Reasoning: The authors did not describe the process for selecting studies.
- Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: Not available.
- Reasoning: The authors did not describe the data collection process.
- Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: Not available.
- Reasoning: The authors did not list and define all variables for which data were sought.
- Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not available.
- Reasoning: The authors did not describe the methods used for assessing risk of bias in individual studies.
- Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: Not available.
- Reasoning: The authors did not state the principal summary measures.
- Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: Not available.
- Reasoning: The authors did not describe the methods of handling data and combining results of studies.
- Response: [No]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not available.
- Reasoning: The authors did not specify any assessment of risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The authors did not describe any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "A total of 21 manuscripts met the inclusion criteria of our systematic review of which 3 were MA and 18 were RCS."
- Reasoning: The authors provided the number of studies included in the review, but did not provide the number of studies screened or assessed for eligibility, or reasons for exclusions.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: Not available.
- Reasoning: The authors did not present the characteristics for each study.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not available.
- Reasoning: The authors did not present data on risk of bias of each study.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: Not available.
- Reasoning: The authors did not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
- Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: Not available.
- Reasoning: The authors did not perform a meta-analysis, so this item is not applicable.
- Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not available.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The authors did not present results of any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Except from one preliminary study and a most recently published pilot study, only RCS on pediatric VATS are available for five different types of procedures. Therefore, the best available evidence according to the CEBM criteria is Level 3."
- Reasoning: The authors summarized the main findings and the strength of evidence.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Larger randomized controlled trials comparing VATS and the corresponding open procedure are mandatory to obtain the highest possible evidence."
- Reasoning: The authors discussed the limitations of their review.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Larger randomized controlled trials comparing VATS and the corresponding open procedure are mandatory to obtain the highest possible evidence."
- Reasoning: The authors provided a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The authors did not describe the sources of funding for the systematic review.
- Response: [No]

86. Dingemann 2013: Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?

LLM response

15 quote(s) from publication full text (mean similarity 99.7%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. Was an 'a priori' design provided?
- Quote: "The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
- Reasoning: The authors clearly stated their research question and inclusion criteria.
- Answer: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: Not available.
- Reasoning: The authors did not mention the use of duplicate study selection and data extraction.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed."
- Reasoning: The authors mentioned the database used for the literature search, but did not provide details about the search strategy or additional sources.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not available.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: Not available.
- Reasoning: The authors did not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
- Reasoning: The authors provided some information about the included studies, but did not provide detailed characteristics.
- Answer: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: Not available.
- Reasoning: The authors did not mention the assessment of the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: Not available.
- Reasoning: The authors did not discuss the scientific quality of the included studies in their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: Not available.
- Reasoning: The authors did not mention any methods used to combine the findings of the included studies.
- Answer: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: Not available.
- Reasoning: The authors did not mention the assessment of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of Interest: None"
- Reasoning: The authors declared no conflict of interest.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?"
- Reasoning: The title clearly identifies the report as a systematic review.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Introduction" [...] "Materials and Methods" [...] "Results" [...] "Conclusion" [...] ""
- Reasoning: The abstract provides a structured summary of the study.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Introduction: The use of laparoscopic techniques has evolved quickly and gained enormous acceptance in pediatric surgery in the last decade."
- Reasoning: The authors provided a rationale for the review in the context of existing knowledge.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
- Reasoning: The authors clearly stated the research question and objectives.
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The authors did not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed."
- Reasoning: The authors specified the study characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "The Web site was last accessed on May 5, 2012."
- Reasoning: The authors mentioned the database used and the date of the last search.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: Not available.
- Reasoning: The authors did not provide a full electronic search strategy.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Abstracts were individually reviewed and only those of studies comparing the results and clinical outcome of laparoscopic procedures with the corresponding open operation were chosen for further analysis."
- Reasoning: The authors described the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: Not available.
- Reasoning: The authors did not describe the data collection process.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: Not available.
- Reasoning: The authors did not list and define all variables for which data were sought.
- Answer: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not available.
- Reasoning: The authors did not describe methods used for assessing risk of bias in individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: Not available.
- Reasoning: The authors did not state the principal summary measures.
- Answer: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: Not available.
- Reasoning: The authors did not describe the methods of handling data and combining results of studies.
- Answer: [NA]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not available.
- Reasoning: The authors did not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The authors did not describe methods of additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
- Reasoning: The authors provided the number of studies included in the review, but did not provide the number of studies screened or assessed for eligibility, reasons for exclusions, or a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: Not available.
- Reasoning: The authors did not present characteristics for each study or provide citations.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not available.
- Reasoning: The authors did not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: Not available.
- Reasoning: The authors did not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: Not available.
- Reasoning: The authors did not present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Answer: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not available.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The authors did not give results of additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Studies meeting the CEBM criteria for Level 1 are available for only seven laparoscopic pediatric surgical procedures."
- Reasoning: The authors summarized the main findings and considered their relevance to healthcare providers.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: Not available.
- Reasoning: The authors did not discuss limitations at the study and outcome level or at the review level.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Effort has to be made to extend the existing Level 1 evidence to open questions concerning these seven procedures and to gain high level evidence for further laparoscopic procedures in pediatric surgery."
- Reasoning: The authors provided a general interpretation of the results and discussed implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The authors did not describe sources of funding for the systematic review.
- Answer: [No]

88. Elyas 2010: Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review

LLM response

26 quote(s) from publication full text (mean similarity 99.2%)

A1. Was an 'a priori' design provided?
- Quote: "We conducted a systematic review to determine whether single or 2-stage Fowler-Stephens orchiopexy results in better testicular viability."
- Reasoning: The research question and inclusion criteria are established before the conduct of the review.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
- Reasoning: The authors mention that data extraction was done independently by each author.
- Response: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "We searched several electronic databases, including MEDLINE®, EMBASE®, CINAHL®, Cochrane Central Register of Control Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and ACP Journal Club®."
- Reasoning: The authors searched multiple databases and provided the names of these databases.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "Reference lists of the selected articles were hand searched for relevant citations, as was potentially relevant gray literature, which consists of studies either not published or not indexed in major databases."
- Reasoning: The authors searched for grey literature and included it in their review.
- Response: [Yes]

A5. Was a list of studies (included and excluded) provided?
- Quote: "A total of 1,807 potentially relevant articles were retrieved from the initial electronic database search and an additional 13 studies from the gray literature search."
- Reasoning: The authors mention the number of articles retrieved but do not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "No included study was a RCT, and only 4 of 61 articles mentioned how or if statistical analysis was performed."
- Reasoning: The authors provide some information about the characteristics of the included studies, but not in a comprehensive manner.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
- Reasoning: The authors mention that they assessed the quality of the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "However, the level of evidence of the studies was low and a study of a more robust design such as a randomized control trial should be performed to evaluate and compare the efficacies of these therapies in the pediatric population."
- Reasoning: The authors considered the quality of the included studies when formulating their conclusions.
- Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Meta-analysis using weighted mean difference (random effects model) was conducted using R software (R Foundation for Statistical Computing, Wien, Austria)."
- Reasoning: The authors used appropriate statistical methods to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: "The funnel plot was roughly symmetrical, suggesting that publication bias was unlikely a significant factor."
- Reasoning: The authors assessed the likelihood of publication bias using a funnel plot.
- Response: [Yes]

A11. Was the conflict of interest included?
- Quote: Not available.
- Reasoning: The full text provided does not mention any conflicts of interest.
- Response: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review"
- Reasoning: The title identifies the report as a systematic review.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: Not available.
- Reasoning: The full text provided does not include an abstract.
- Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Fowler and Stephens showed that by dividing the spermatic vessels a high intra-abdominal testis could be placed in the scrotum. Testicular atrophy is a potential complication of this technique."
- Reasoning: The authors provide a rationale for the review in the context of what is already known.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "We evaluated whether single stage or 2-stage FSO results in greater testicular viability in children younger than 18 years with intra-abdominal testes."
- Reasoning: The authors provide an explicit statement of the research question being addressed.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The full text provided does not mention a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Studies were considered relevant if they met the following inclusion criteria. Patients were younger than 18 years, had an intra-abdominal testis, had undergone single or 2-stage FSO (open or laparoscopic), and had data regarding testicular size and position available postoperatively."
- Reasoning: The authors specify the eligibility criteria for the studies included in the review.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "We searched several electronic databases, including MEDLINE®, EMBASE®, CINAHL®, Cochrane Central Register of Control Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and ACP Journal Club®."
- Reasoning: The authors describe the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The search strategy used in MEDLINE (Ovid interface) was Fowler Stephens.mp.; orchidopexy.mp.; orchiopexy.mp.; Laparoscopy [Abnormalities, Adverse Effects, Classification, Standards, Statistics and Numerical Data, Surgery, Methods, Trends, Utiliza- tion].; or/1-4.; Cryptorchi$.mp.; Undescended test$.mp.; Initial search n = 1807 Non-relevant abstracts and duplicates excluded n = 1660 Grey Literature, conference proceedings, reference lists n = 13 Hard copies of papers and/or abstracts obtained. n = 160 Non-English and non-relevant papers excluded. n = 61 Final exclusion for relevance n = 38 excluded Studies included in review n = 61 Citations underwent review n = 99 Figure 1. Flowchart of excluded and included articles STAGED FOWLER-STEPHENS ORCHIOPEXY 2013"
- Reasoning: The authors present the full electronic search strategy for one database.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "All of the identified abstracts were imported into an electronic database (RefWorks, Bethesda, Maryland) and underwent initial screening for relevance by 2 of us. Hard copies of potentially relevant records were obtained and a more focused screening excluded additional documents."
- Reasoning: The authors describe the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
- Reasoning: The authors describe the method of data extraction from reports.
- Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The primary outcome was testicular viability, which was defined as adequate postoperative testicular size and position in the scrotum. Secondary outcomes were perioperative and postoperative complications."
- Reasoning: The authors list and define the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "Each author was allocated roughly 10 articles, and independently abstracted the data and assessed the quality of the reports."
- Reasoning: The authors describe the methods used for assessing the risk of bias of individual studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Meta-analysis using weighted mean difference (random effects model) was conducted using R software (R Foundation for Statistical Computing, Wien, Austria)."
- Reasoning: The authors state the principal summary measures used in the review.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Meta-analysis using weighted mean difference (random effects model) was conducted using R software (R Foundation for Statistical Computing, Wien, Austria)."
- Reasoning: The authors describe the methods of handling data and combining results of studies.
- Response: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: "The funnel plot was roughly symmetrical, suggesting that publication bias was unlikely a significant factor."
- Reasoning: The authors specify an assessment of risk of bias that may affect the cumulative evidence.
- Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The full text provided does not mention any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "A total of 1,807 potentially relevant articles were retrieved from the initial electronic database search and an additional 13 studies from the gray literature search. After a thorough assessment 99 articles underwent a full review for evaluation of quality and data abstraction by the entire team. Ultimately 61 articles were included in the review."
- Reasoning: The authors provide the numbers of studies screened, assessed for eligibility, and included in the review.
- Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Of the articles 9 (204 testes) included success rates of single stage FSO. The pooled estimate of success rate was 80% (95% CI 75 to 86) and the I2, a measurement of heterogeneity, was 11% (fig. 2). Among the 36 articles (751 testes) including success rates of 2-stage FSO the pooled estimate of success rate was 85% (95% CI 81 to 90) and the I2 was 43% (fig. 3)."
- Reasoning: The authors present characteristics for each study, but do not provide the citations.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not available.
- Reasoning: The full text provided does not present data on risk of bias of each study.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Of the articles 9 (204 testes) included success rates of single stage FSO. The pooled estimate of success rate was 80% (95% CI 75 to 86) and the I2, a measurement of heterogeneity, was 11% (fig. 2). Among the 36 articles (751 testes) including success rates of 2-stage FSO the pooled estimate of success rate was 85% (95% CI 81 to 90) and the I2 was 43% (fig. 3)."
- Reasoning: The authors present summary data and effect estimates for each study, and use forest plots.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "The pooled estimate of success rates was 80% for single stage Fowler-Stephens orchiopexy (95% CI 75 to 86) and 85% for 2-stage Fowler-Stephens orchiopexy (95% CI 81 to 90)."
- Reasoning: The authors present the results of the meta-analysis, including confidence intervals.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: "The funnel plot was roughly symmetrical, suggesting that publication bias was unlikely a significant factor."
- Reasoning: The authors present the results of an assessment of risk of bias across studies.
- Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The full text provided does not mention any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Based on the results of this review, both approaches have a fairly high success rate, although 2-stage FSO appears to carry a higher rate of success over the single stage procedure, defined as postoperative viability of the testis (85% vs 80%, OR 2 in favor of 2-stage)."
- Reasoning: The authors summarize the main findings and the strength of evidence for each main outcome.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "The strength of this study was limited by several factors. This systematic review failed to identify any RCTs comparing success rates of single vs 2-stage FSO. The studies included consisted almost entirely of retrospective cohort or case series, with only 16 reports comparing single to 2-stage repair."
- Reasoning: The authors discuss the limitations of the study.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "However, the level of evidence of the studies was low and a study of a more robust design such as a randomized control trial should be performed to evaluate and compare the efficacies of these therapies in the pediatric population."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The full text provided does not mention any sources of funding for the systematic review.
- Response: [No]

89. Esposito 2014: Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

LLM response

26 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of this review is to analyze the current literature to determine the outcome of LH compared with OH."
- Reasoning: The authors stated the research question and inclusion criteria, but there is no mention of a protocol or ethics approval.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "The authors independently assessed selected studies and tabulated data from each article with a predefined data extraction form."
- Reasoning: The authors mentioned that they independently assessed the studies, indicating a duplicate study selection and data extraction process.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "A literature search was performed using PubMed, Cochrane, and Medline databases on all studies published during the last 20 years."
- Reasoning: The authors used multiple databases for their search and provided the years of coverage, indicating a comprehensive literature search.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "Conference abstracts were excluded because of the limited data presented in them."
- Reasoning: The authors mentioned the exclusion of conference abstracts, but there is no explicit statement about the inclusion or exclusion of grey literature.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "We recorded 171 studies, but 118 of these were excluded from our analysis using the following criteria" [...] ""
- Reasoning: The authors mentioned the number of studies included and excluded, but did not provide a list of these studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "All studies showed a total population of 19,022 children and adolescents (age, 0–18 years) who underwent hernia repair by laparoscopic (LH) (11,591 cases, 60.9%) or open (OH) (7440 cases, 39.1%) techniques and reported operative time, postoperative recurrence and complications, conversion rate, rare hernias, and incidence of contralateral patency."
- Reasoning: The authors provided aggregated data on the participants, interventions, and outcomes of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Eligibility criteria included all available studies focused on LH and/or OH and with quantitative data on outcome parameters."
- Reasoning: The authors mentioned eligibility criteria for the studies, but there is no explicit assessment of the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "In conclusion, we think that there is no evidence in the literature about which technique (laparoscopy or inguinal approach) is preferable to repair an inguinal hernia."
- Reasoning: The authors formulated their conclusions based on the results of the included studies, but since the scientific quality of the studies was not assessed (A7), this question cannot be scored as "yes".
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "The chi-squared or Fisher’s exact test was used to evaluate the significance of differences between the two groups: LH and OH."
- Reasoning: The authors used statistical methods to combine the findings of the studies, indicating an appropriate method of data synthesis.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: Not applicable.
- Reasoning: The authors did not mention any assessment of publication bias in their review.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: "Disclosure Statement: No competing financial interests exist."
- Reasoning: The authors provided a disclosure statement, indicating that they acknowledged potential sources of conflict of interest.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review"
- Reasoning: The title clearly identifies the report as a systematic review.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Aim: Inguinal hernia is one of the most common surgical conditions in infants and children. However, considerable debate exists regarding the role of laparoscopic hernia repair (herniorrhaphy) (LH) and its benefits over conventional open hernia repair (herniorrhaphy) (OH). The aim of this review is to analyze the current literature to determine the outcome of LH compared with OH."
- Reasoning: The abstract provides a structured summary of the review, including the background, objectives, methods, and results.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Inguinal hernia is one of the most common surgical conditions in infants and children. However, considerable debate exists regarding the role of laparoscopic hernia repair (herniorrhaphy) (LH) and its benefits over conventional open hernia repair (herniorrhaphy) (OH)."
- Reasoning: The authors provided a rationale for the review in the context of the existing debate over laparoscopic versus open hernia repair.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "This review aims to evaluate the role of LH in children and to compare LH with OH in regard to operative time, postoperative complications, recurrence rate, discovering of rare hernias, and incidence of contralateral patency."
- Reasoning: The authors provided an explicit statement of the research question, including the participants (children), interventions (LH and OH), comparisons (LH versus OH), and outcomes (operative time, complications, recurrence rate, rare hernias, contralateral patency).
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not applicable.
- Reasoning: The authors did not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Eligibility criteria included all available studies focused on LH and/or OH and with quantitative data on outcome parameters. The pediatric population was defined as younger than 18 years when the patient underwent LH or OH."
- Reasoning: The authors specified the study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A literature search was performed using PubMed, Cochrane, and Medline databases on all studies published during the last 20 years."
- Reasoning: The authors described the information sources used in the search, but did not provide the date of the last search.
- Answer: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The following key words were used: ‘‘inguinal hernia,’’ ‘‘herniorrhaphy,’’ ‘‘hernia repair,’’ ‘‘children,’’ ‘‘laparoscopic versus open herniorrhaphy,’’ ‘‘laparoscopic versus open hernia repair,’’ ‘‘contralateral patency,’’ ‘‘complications,’’ and ‘‘re- currence.’’ Searches were also performed using the following as limits: clinical trials, randomized controlled trials, multicenter retrospective, prospective studies, and expert opinion."
- Reasoning: The authors provided the key words and limits used in their search strategy, but did not specify which database this strategy was used for.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "After relevant titles were identified, the abstracts of these studies were read to decide if the study was eligible. The full article was retrieved when the information in the title and/or abstract appeared to meet the objective of our review."
- Reasoning: The authors described the process for selecting studies, including screening and eligibility assessment.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "The authors independently assessed selected studies and tabulated data from each article with a predefined data extraction form."
- Reasoning: The authors described the method of data extraction from the reports.
- Answer: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Data regarding the following factors were considered: first author, publication date, study method, participant features, intervention characteristics, definition of complications, and outcome measures."
- Reasoning: The authors listed and defined the variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not applicable.
- Reasoning: The authors did not describe any methods used for assessing the risk of bias in the individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "The chi-squared or Fisher’s exact test was used to evaluate the significance of differences between the two groups: LH and OH."
- Reasoning: The authors stated the principal summary measures used in their review.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "The chi-squared or Fisher’s exact test was used to evaluate the significance of differences between the two groups: LH and OH."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not applicable.
- Reasoning: The authors did not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not applicable.
- Reasoning: The authors did not describe any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "We recorded 171 studies, but 118 of these were excluded from our analysis using the following criteria" [...] ""
- Reasoning: The authors provided the numbers of studies screened, assessed for eligibility, and included in the review, but did not provide a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "All studies showed a total population of 19,022 children and adolescents (age, 0–18 years) who underwent hernia repair by laparoscopic (LH) (11,591 cases, 60.9%) or open (OH) (7440 cases, 39.1%) techniques and reported operative time, postoperative recurrence and complications, conversion rate, rare hernias, and incidence of contralateral patency."
- Reasoning: The authors presented the characteristics of the included studies, but did not provide the citations for each study.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not applicable.
- Reasoning: The authors did not present data on the risk of bias within each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "The mean operative time for the repair of unilateral inguinal hernia was 30.1 minutes via the open approach and 23.7 minutes via laparoscopy, with no significant difference between the two techniques (P = .33)."
- Reasoning: The authors presented summary data and effect estimates for each intervention group, but did not provide a forest plot.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: Not applicable.
- Reasoning: This is a systematic review, not a meta-analysis, so this item is not applicable.
- Answer: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not applicable.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not applicable.
- Reasoning: The authors did not conduct any additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "In conclusion, we think that there is no evidence in the literature about which technique (laparoscopy or inguinal approach) is preferable to repair an inguinal hernia."
- Reasoning: The authors summarized the main findings of their review.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: Not applicable.
- Reasoning: The authors did not discuss the limitations of their review.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "In conclusion, we think that there is no evidence in the literature about which technique (laparoscopy or inguinal approach) is preferable to repair an inguinal hernia."
- Reasoning: The authors provided a general interpretation of the results and suggested the need for further research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "Disclosure Statement: No competing financial interests exist."
- Reasoning: The authors provided a disclosure statement, but did not describe the sources of funding for the review.
- Answer: [No]

90. Feng 2016: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis

LLM response

27 quote(s) from publication full text (mean similarity 99.6%)

A1. Was an 'a priori' design provided?
- Quote: "We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
- Reasoning: The authors stated their research question and the method (systematic review and meta-analysis) they would use to answer it.
- Answer: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
- Reasoning: The authors used two independent reviewers for study selection and data extraction, and a third reviewer for resolving discrepancies.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
- Reasoning: The authors searched three databases and specified the years of coverage.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "Studies comparing LS and OS in children were included regardless of randomization or non-randomization."
- Reasoning: The authors did not specify whether they included grey literature in their search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria."
- Reasoning: The authors mentioned the number of included studies but did not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Tables 1, 2 and 3 outlines the primary and secondary outcome results from each study."
- Reasoning: The authors provided tables summarizing the characteristics of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention assessing the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention the scientific quality of the included studies in their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "For continuous data, we presented mean differences (MDs) with 95 % confidence intervals (CIs). For dichotomous data, we calculated odds ratios (ORs)."
- Reasoning: The authors described the methods they used to combine the findings of the studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention assessing the likelihood of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: "Acknowledgments The manuscript had been proofread by Professor Xin-He Lai, Institute of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China."
- Reasoning: The authors acknowledged the contribution of a third party but did not explicitly state any conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis"
- Reasoning: The title identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract Purpose We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
- Reasoning: The abstract provides a structured summary of the study.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Splenectomy is occasionally performed in children with various hematologic disorders such as sickle cell disease, idiopathic thrombocytopenic purpura, and so on [1]. Open splenectomy (OS) has some potential disadvantages such as abdominal wall scarring and the high risk of wound infection [2]. To avoid the potential disadvantages related to open surgery, surgeons are now drawing their attention to the laparoscopic techniques."
- Reasoning: The authors described the rationale for the review in the context of what is already known.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
- Reasoning: The authors provided an explicit statement of the questions being addressed.
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors did not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Inclusion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015; (2) children under 18 years old who suffered from benign or malignant hematological diseases; exclusion criteria: (1) no open splenectomy as a control; (2) reports fewer than ten cases per group; and (3) studies did not provide available original data or duplicate publications."
- Reasoning: The authors specified the study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015."
- Reasoning: The authors described the information sources and the dates of coverage.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The search terms laparoscopic splenectomy, pediatrics, open splenectomy, minimally invasive and children were used individually and in combination."
- Reasoning: The authors presented the search terms used but did not provide a full electronic search strategy.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
- Reasoning: The authors stated the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
- Reasoning: The authors described the method of data extraction from reports.
- Answer: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay. Secondary outcome measures included an analysis of the removal of accessory spleens and postoperative complications including postoperative high fever, acute chest syndrome (ACS), and ileus."
- Reasoning: The authors listed and defined all variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe methods used for assessing risk of bias of individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "For continuous data, we presented mean differences (MDs) with 95 % confidence intervals (CIs). For dichotomous data, we calculated odds ratios (ORs)."
- Reasoning: The authors stated the principal summary measures.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Review Manager (RevMan) software ver. 5.3 was applied for data statistical analysis. For continuous data, we presented mean differences (MDs) with 95 % confidence intervals (CIs). For dichotomous data, we calculated odds ratios (ORs). Statistical heterogeneity in the meta-analysis was assessed with the v2 test and the I2 index. A random-effects model was used in case of heterogeneous data. Otherwise, a fixed-effects model was used instead."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors did not specify any assessment of risk of bias that may affect the cumulative evidence.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe methods of additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "As shown in Fig. 1 of the workflow, 21 of the 159 publications identified from the initial literature search were retrieved for full text review and 10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria."
- Reasoning: The authors gave numbers of studies screened, assessed for eligibility, and included in the review, with a flow diagram.
- Answer: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Tables 1, 2 and 3 outlines the primary and secondary outcome results from each study."
- Reasoning: The authors presented characteristics for each study in tables.
- Answer: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors did not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Tables 2 and 3 outlines the primary and secondary outcome results from each study."
- Reasoning: The authors presented simple summary data for each intervention group and effect estimates for each study in tables.
- Answer: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Meta-analysis demonstrated that the LS approach had a significantly longer operative time than the OS approach with obvious statistical heterogeneity (I2 = 99 %, WMD 42.22, 95 % CI 7.69–76.74; P = 0.02; Fig. 2)."
- Reasoning: The authors presented results of each meta-analysis done, including confidence intervals and measures of consistency.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors did not give results of additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS."
- Reasoning: The authors summarized the main findings and considered their relevance to key groups.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Our systematic review and meta-analysis have several limitations. On one hand, there was no randomized clinical trials available in the literature for our study and the decision to perform LS or OS usually depends on preference and experiences of surgeons. Besides, some of the included studies had rather small sample size. On the other hand, obvious statistical heterogeneity was detected among different trials in terms of operative time, blood loss, and length of hospital stay."
- Reasoning: The authors discussed limitations at the study and review level.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS. Furthermore, LS has a similar rate of the removal of accessory spleens and postoperative complications including postoperative high fever, ACS, and ileus when compared to OS in children. However, none of the ten studies included in our meta-analysis were randomized. Randomized controlled trials of high quality are definitely necessary and needed in the future to make our results more convincing and conclusive."
- Reasoning: The authors provided a general interpretation of the results in the context of other evidence, and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "Acknowledgments The manuscript had been proofread by Professor Xin-He Lai, Institute of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China."
- Reasoning: The authors acknowledged the contribution of a third party but did not explicitly state any sources of funding for the systematic review.
- Answer: [No]

91. Feng 2015: Open Versus Laparoscopic Inguinal Herniotomy in Children

LLM response

25 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
- Reasoning: The authors clearly stated their research question and objectives before conducting the review.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: "Two reviewers (S.F., Z.L.) screened the citation identified by the search strategy."
- Reasoning: The authors mentioned that two reviewers were involved in the study selection process, but they did not mention if the data extraction was also done by two independent reviewers.
- Response: [No]

A3. Was a comprehensive literature search performed?
- Quote: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords “laparoscopic herniorrhaphy”, “pediatric inguinal hernia,” and “open herniorrhaphy.” Total reference lists of selected articles were also included."
- Reasoning: The authors described their search strategy, including the database used and the keywords, but they only used one database, which does not meet the requirement of at least two electronic sources.
- Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not provided.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: Not provided.
- Reasoning: The authors did not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Five randomized clinical trials with a total of 553 children (OH 278, LH 275) fulfilled the inclusion criteria and were analyzed in this review."
- Reasoning: The authors provided some characteristics of the included studies, but they did not provide detailed information such as age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases.
- Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
- Reasoning: The authors mentioned that they assessed the quality of the included studies.
- Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "This meta-analysis favors LH in the repair of bilateral hernias and for unilateral hernias in extraperitoneal approaches’ group. Total postoperative complications were significantly reduced in LH, especially for major postoperative complications in male children."
- Reasoning: The authors' conclusions are based on the results of their analysis of the included studies, but they did not explicitly state how the quality of the studies influenced their conclusions.
- Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "Weighted mean differences and odds ratios were used for the analysis of continuous and dichotomous variables, respectively."
- Reasoning: The authors described the statistical methods they used to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: Not provided.
- Reasoning: The authors did not mention whether they assessed the likelihood of publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "The authors declare no conflicts of interest."
- Reasoning: The authors declared that they had no conflicts of interest.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Open Versus Laparoscopic Inguinal Herniotomy in Children: A Systematic Review and Meta-Analysis Focusing on Postoperative Complications"
- Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: The abstract is provided at the beginning of the full text.
- Reasoning: The abstract includes the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, and conclusions.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "There is an ongoing debate about whether laparoscopic or open herniorrhaphy (LH or OH) is the best choice for inguinal hernia in children."
- Reasoning: The authors provided a rationale for their review in the context of the ongoing debate about the best surgical strategy for inguinal hernia in children.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of this study was to compare both of the surgical strategies as regards operative time, recurrence rate, postoperative complications by means of a systematic review, and meta-analysis of the available literatures."
- Reasoning: The authors provided an explicit statement of the questions being addressed, including the participants (children), interventions (laparoscopic or open herniorrhaphy), comparisons (between the two surgical strategies), and outcomes (operative time, recurrence rate, postoperative complications).
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not provided.
- Reasoning: The authors did not mention whether a review protocol exists or provide any registration information.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Eligibility criteria included total available studies comparing LH with OH for the repair of PIH. The children were younger than 18 years when they underwent LH or OH."
- Reasoning: The authors specified the study characteristics and report characteristics used as criteria for eligibility.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords “laparoscopic herniorrhaphy”, “pediatric inguinal hernia,” and “open herniorrhaphy.” Total reference lists of selected articles were also included."
- Reasoning: The authors described the information source (PubMed) and the date range of their search, but they did not mention the date of the last search.
- Response: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "We systematically searched PubMed for relevant studies reported from 2005 to 2014 with the keywords “laparoscopic herniorrhaphy”, “pediatric inguinal hernia,” and “open herniorrhaphy.”"
- Reasoning: The authors presented their search strategy for one database (PubMed), including the keywords used, but they did not mention any limits used.
- Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Two reviewers (S.F., Z.L.) screened the citation identified by the search strategy."
- Reasoning: The authors stated the process for selecting studies, including screening by two reviewers.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "The first author independently extracted data from the included studies."
- Reasoning: The authors described the method of data extraction, but they did not mention any processes for obtaining and confirming data from investigators.
- Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Details of publication (type of repairing the internal ring, trocars, and follow-up duration), inclusion and exclusion criteria, and demographics of the enrolled patients were collected and collated."
- Reasoning: The authors listed and defined the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: "Quality of the RCTs was assessed, including randomization, method of blinding, and allocation concealment."
- Reasoning: The authors described the methods used for assessing the risk of bias of individual studies.
- Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Weighted mean differences and odds ratios were used for the analysis of continuous and dichotomous variables, respectively."
- Reasoning: The authors stated the principal summary measures used in their analysis.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "Review Manager (RevMan) software, version 5.3 was used for data statistical analysis. Weighted mean differences and odds ratios were used for the analysis of continuous and dichotomous variables, respectively."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Response: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not provided.
- Reasoning: The authors did not specify any assessment of risk of bias that may affect the cumulative evidence.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not provided.
- Reasoning: The authors did not describe any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Five randomized clinical trials with a total of 553 children (OH 278, LH 275) fulfilled the inclusion criteria and were analyzed in this review."
- Reasoning: The authors gave the number of studies included in the review, but they did not provide the numbers of studies screened and assessed for eligibility, nor did they provide reasons for exclusions at each stage or a flow diagram.
- Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Five randomized clinical trials with a total of 553 children (OH 278, LH 275) fulfilled the inclusion criteria and were analyzed in this review."
- Reasoning: The authors presented some characteristics for each study, but they did not provide the citations.
- Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not provided.
- Reasoning: The authors did not present data on the risk of bias of each study or any outcome level assessment.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Compared with OH, shorter operative time for unilateral hernias was noted in extraperitoneal approaches’ group [95% confidence interval (CI), 6.71 to 3.71; I2 = 0%] as well as for bilateral hernias (95% CI, 12.18 to 3.79; I2 = 82%)."
- Reasoning: The authors presented the results of individual studies, including simple summary data for each intervention group and effect estimates and confidence intervals.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Compared with OH, shorter operative time for unilateral hernias was noted in extraperitoneal approaches’ group [95% confidence interval (CI), 6.71 to 3.71; I2 = 0%] as well as for bilateral hernias (95% CI, 12.18 to 3.79; I2 = 82%)."
- Reasoning: The authors presented the results of their meta-analysis, including confidence intervals and measures of consistency.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not provided.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not provided.
- Reasoning: The authors did not give results of any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Our results show that LH is superior for the inguinal hernia repair in children, with shorter operative time for unilateral hernias in extraperitoneal approaches group as well as for bilateral hernias."
- Reasoning: The authors summarized their main findings and considered their relevance to key groups.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: Not provided.
- Reasoning: The authors did not discuss limitations at the study and outcome level or at the review level.
- Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "This meta-analysis favors LH in the repair of bilateral hernias and for unilateral hernias in extraperitoneal approaches’ group. Total postoperative complications were significantly reduced in LH, especially for major postoperative complications in male children."
- Reasoning: The authors provided a general interpretation of their results and discussed the implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "The authors declare no conflicts of interest."
- Reasoning: The authors did not describe the sources of funding for the systematic review or the role of the funders.
- Response: [No]

92. Friedmacher 2011: Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis

LLM response

13 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "We designed this meta-analysis to determine the incidence and outcome of RA among patients with HD following PT operation."
- Reasoning: The authors state that they designed the meta-analysis, but they do not mention a protocol or pre-determined objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the process of study selection and data extraction.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
- Reasoning: The authors mention two databases and the time frame for the search, but they do not provide keywords or MESH terms.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The text does not mention whether grey literature was included in the search.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation."
- Reasoning: The authors mention the number of articles included, but they do not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
- Reasoning: The authors provide a list of characteristics that were recorded from the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The text does not mention any assessment of the scientific quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the use of the scientific quality of the included studies in formulating conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: No relevant quote found.
- Reasoning: The text does not mention the methods used to combine the findings of the studies.
- Answer: [No]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The text does not mention an assessment of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: No relevant quote found.
- Reasoning: The text does not mention any conflicts of interest.
- Answer: [No]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis"
- Reasoning: The title clearly identifies the report as a systematic review and meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Purpose Most patients with Hirschsprung’s disease (HD) have a satisfactory outcome after pull-through (PT) operation. However, some children continue to have persistent bowel symptoms after the initial operation and may require redo PT. Redo PT operation in HD is usually indicated for anastomotic strictures or residual aganglionosis (RA). We designed this meta-analysis to determine the incidence and outcome of RA among patients with HD following PT operation."
- Reasoning: The abstract provides a summary of the background, objectives, and methods, but it does not include all the required elements such as data sources, study eligibility criteria, participants, interventions, results, limitations, conclusions, and implications of key findings.
- Answer: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Pull-through (PT) operations for Hirschsprung’s disease (HD) generally result in a satisfactory outcome [1]. However, some patients after definitive PT operation have disturbances of bowel function such as constipation, enterocolitis and recurrent obstructive symptoms [2–9]."
- Reasoning: The introduction provides a rationale for the review in the context of what is already known.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "We designed this meta-analysis to determine the incidence and outcome of residual aganglionosis (RA) in patients with HD following PT operation."
- Reasoning: The authors provide an explicit statement of the questions being addressed, but they do not reference all elements of PICOS.
- Answer: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The text does not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
- Reasoning: The authors specify the years considered and the type of studies included, but they do not provide a full description of the eligibility criteria.
- Answer: [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or transition-zone bowel (TZB) after initial operation between 1985 and 2011."
- Reasoning: The authors describe the databases used and the dates of coverage, but they do not mention the date of the last search.
- Answer: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "The search terms were ‘‘residual aganglionosis’’, ‘‘transition-zone bowel’’, ‘‘redo and repeat pull-through’’, ‘‘reoperation Hirschsprung’s disease’’ and ‘‘postoperative follow-up and outcome Hirschsprung’s disease’’."
- Reasoning: The authors provide the search terms used, but they do not present a full electronic search strategy that could be repeated.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: No relevant quote found.
- Reasoning: The text does not describe the process for selecting studies.
- Answer: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
- Reasoning: The authors describe the data that was extracted, but they do not describe the process of data extraction.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
- Reasoning: The authors list the variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The text does not describe methods used for assessing risk of bias in individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: No relevant quote found.
- Reasoning: The text does not state the principal summary measures.
- Answer: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: No relevant quote found.
- Reasoning: The text does not describe the methods of handling data and combining results of studies.
- Answer: [No]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The text does not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The text does not describe any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation."
- Reasoning: The authors provide the number of studies included in the review, but they do not give the numbers of studies screened and assessed for eligibility, nor the reasons for exclusions.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
- Reasoning: The authors describe the characteristics for which data were extracted, but they do not provide this information for each study.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The text does not present data on risk of bias within studies.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: No relevant quote found.
- Reasoning: The text does not present results of individual studies.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: No relevant quote found.
- Reasoning: The text does not present results of a meta-analysis.
- Answer: [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The text does not present results of an assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The text does not present results of additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "This meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients with HD requiring redo PT operation. Most patients have a satisfactory outcome after redo operation."
- Reasoning: The authors summarize the main findings of the review.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: No relevant quote found.
- Reasoning: The text does not discuss limitations at the study, outcome, or review level.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "This meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients with HD requiring redo PT operation. Most patients have a satisfactory outcome after redo operation."
- Reasoning: The authors provide a general interpretation of the results, but they do not discuss the implications for future research.
- Answer: [No]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The text does not describe sources of funding for the systematic review.
- Answer: [No]

93. Friedmacher 2012: Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome

LLM response

23 quote(s) from publication full text (mean similarity 99.9%)

A1. Was an 'a priori' design provided?
- Quote: "This meta-analysis aimed to investigate the complications and long-term outcome in patients with LGEA managed by DPA."
- Reasoning: The authors state the research question but do not mention a protocol or pre-determined objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "Identified articles were reviewed by title, keywords and abstract by one of the authors (F.F.). An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.)."
- Reasoning: The authors mention that two authors independently performed the full-text assessment, but it is not clear if this process was applied to study selection and data extraction.
- Answer: [No]

A3. Was a comprehensive literature search performed?
- Quote: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA. Common electronic databases as MEDLINE, EMBASE, ISI Web of Science and the Cochrane Library were searched in December 2011 using a combination of the following terms: ‘‘esophageal atresia’’, ‘‘long-gap’’ and ‘‘delayed primary anastomosis’’. References lists of identified articles were screened for additional studies."
- Reasoning: The authors describe a comprehensive search strategy using multiple databases and reference lists.
- Answer: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention searching for grey literature or including/excluding studies based on publication status.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: No relevant quote found.
- Reasoning: The authors do not provide a list of included and excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies)."
- Reasoning: The authors provide a detailed description of the characteristics of the included studies.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention assessing the quality of the included studies.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors do not discuss the quality of the included studies in their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "With these data, a cumulative meta-analysis was performed. This enabled the calculation of incidences with a 95 % confidence interval (CI) for each specific complication."
- Reasoning: The authors describe using a meta-analysis to combine the findings of the included studies.
- Answer: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors do not mention assessing for publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of interest The authors declare that they have no conflict of interests."
- Reasoning: The authors declare any potential conflicts of interest.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome"
- Reasoning: The title identifies the report as a meta-analysis.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract Purpose Management of newborns with long-gap esophageal atresia (LGEA) remains a challenge for pediatric surgeons" [...] "Conclusion DPA provides good long-term functional results. However, the high incidence of GER and associated strictures requires early intervention to prevent feeding problems."
- Reasoning: The abstract provides a structured summary of the study, including the background, objectives, methods, results, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Esophageal atresia (EA) is a relatively common congenital malformation of unknown etiology with an incidence of 1 in 3,500 live births" [...] "Thus, surgical management of patients with LGEA represents a major challenge to most pediatric surgeons."
- Reasoning: The authors provide a rationale for the review in the context of the current understanding of esophageal atresia.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The objective of this study was to investigate the complications and long-term outcome in patients with LGEA managed by DPA based on a meta-analysis of the published literature."
- Reasoning: The authors provide an explicit statement of the research question, including the participants (patients with LGEA), intervention (DPA), and outcomes (complications and long-term outcome).
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors do not mention a review protocol or registration.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "A systematic literature search was performed to identify articles reporting cases of LGEA managed by DPA" [...] "All articles that did not contain original research data (e.g. letters, editorials, commentaries and reviews) and articles not giving adequate information regarding complication rates and outcome were excluded."
- Reasoning: The authors specify the eligibility criteria for the included studies.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "Common electronic databases as MEDLINE, EMBASE, ISI Web of Science and the Cochrane Library were searched in December 2011 using a combination of the following terms: ‘‘esophageal atresia’’, ‘‘long-gap’’ and ‘‘delayed primary anastomosis’’. References lists of identified articles were screened for additional studies."
- Reasoning: The authors describe the information sources and the date of the last search.
- Answer: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "Common electronic databases as MEDLINE, EMBASE, ISI Web of Science and the Cochrane Library were searched in December 2011 using a combination of the following terms: ‘‘esophageal atresia’’, ‘‘long-gap’’ and ‘‘delayed primary anastomosis’’."
- Reasoning: The authors present the search strategy, but do not provide enough detail for it to be repeated.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Identified articles were reviewed by title, keywords and abstract by one of the authors (F.F.). An unblinded, standardized full-text assessment of relevant articles was independently performed by both authors (F.F. and P.P.)."
- Reasoning: The authors describe the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "The data was extracted into an electronic data-sheet in a standardized manner."
- Reasoning: The authors describe the data extraction process, but do not mention if it was done independently or in duplicate.
- Answer: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies)."
- Reasoning: The authors list the variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe methods for assessing risk of bias in the included studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "With these data, a cumulative meta-analysis was performed. This enabled the calculation of incidences with a 95 % confidence interval (CI) for each specific complication."
- Reasoning: The authors state that incidences with a 95% confidence interval were the principal summary measures.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "With these data, a cumulative meta-analysis was performed. This enabled the calculation of incidences with a 95 % confidence interval (CI) for each specific complication."
- Reasoning: The authors describe the methods of handling data and combining results of studies.
- Answer: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors do not specify any assessment of risk of bias across studies.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe any additional analyses.
- Answer: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "The literature search resulted in a total of 223 articles, of which 207 were identified by electronic database search and 16 by cross-referencing" [...] "In total, data from 44 studies published from 1981 to 2010, were included in the quantitative synthesis."
- Reasoning: The authors provide numbers of studies screened, assessed for eligibility, and included in the review, but do not provide reasons for exclusions at each stage or a flow diagram.
- Answer: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "Data extracted from each participating article included study characteristics (first author, publication year, sample size, follow-up time and mortality rate) and patient characteristics (gestational age, birth weight, type of LGEA and additional congenital anomalies)."
- Reasoning: The authors present the characteristics for which data were extracted for each study, but do not provide the citations.
- Answer: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors do not present data on risk of bias within studies.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: No relevant quote found.
- Reasoning: The authors do not present simple summary data or effect estimates and confidence intervals for each study.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "With these data, a cumulative meta-analysis was performed. This enabled the calculation of incidences with a 95 % confidence interval (CI) for each specific complication."
- Reasoning: The authors present the results of the meta-analysis, including confidence intervals.
- Answer: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors do not present results of any additional analyses.
- Answer: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "In conclusion, this meta-analysis shows that the DPA provides good long-term functional results. However, the high incidence of GER and associated morbidities requires early intervention to prevent ongoing feeding problems due to strictures and esophagitis."
- Reasoning: The authors summarize the main findings and their relevance to healthcare providers.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: No relevant quote found.
- Reasoning: The authors do not discuss limitations at the study, outcome, or review level.
- Answer: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "In conclusion, this meta-analysis shows that the DPA provides good long-term functional results. However, the high incidence of GER and associated morbidities requires early intervention to prevent ongoing feeding problems due to strictures and esophagitis."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors do not describe sources of funding for the systematic review.
- Answer: [No]

94. Frongia 2013: Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

LLM response

27 quote(s) from publication full text (mean similarity 99.6%)

A1. Was an 'a priori' design provided?
- Quote: "A systematic literature search was carried out using the search terms “bowel lengthening”, “intestinal lengthening”, “longitudinal intestinal lengthening and tailoring”, “LILT”, “Bianchi procedure”, “serial transverse enteroplasty” and “step procedure”. The last search was done on December, 10th, 2012."
- Reasoning: The authors describe a systematic literature search, but do not mention a pre-established protocol or research objectives.
- Answer: [No]

A2. Was there duplicate study selection and data extraction?
- Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN)."
- Reasoning: The authors describe a process where one reviewer screened and extracted data, and two other reviewers checked the data extraction.
- Answer: [Yes]

A3. Was a comprehensive literature search performed?
- Quote: "A systematic literature search was carried out using the search terms “bowel lengthening”, “intestinal lengthening”, “longitudinal intestinal lengthening and tailoring”, “LILT”, “Bianchi procedure”, “serial transverse enteroplasty” and “step procedure”. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
- Reasoning: The authors describe a systematic literature search with multiple search terms and cross-screening of reference lists, but do not specify the databases used.
- Answer: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: "The articles were included in this review if they met the following criteria: Population: Studies of humans aged 0–18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included."
- Reasoning: The authors do not mention whether they included grey literature or unpublished studies in their review.
- Answer: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "Finally n = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here (Table 1)."
- Reasoning: The authors provide a list of included studies, but do not provide a list of excluded studies.
- Answer: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "The median follow-up length in LILT reports was 51.8 months (6–111 months) [9,11,12,14,17–20,22–27,29–32], with reports of LILT series of even more than 20 years [9,23,32], while the median follow-up length in STEP reports was 23.0 months (12–68 months) [6,37,39–44], with maximum follow-up period of 5.7 years after STEP [43]."
- Reasoning: The authors provide some characteristics of the included studies, such as the median follow-up length.
- Answer: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: "Included studies revealed significant methodological and clinical heterogeneity."
- Reasoning: The authors mention that the included studies have significant methodological and clinical heterogeneity, but do not provide a detailed assessment of the scientific quality of each study.
- Answer: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: "Nevertheless there are some limitations to be mentioned, as detailed evaluation of the impact of both procedures in children is limited by the nature of available reports."
- Reasoning: The authors acknowledge the limitations of the included studies in their conclusions, but do not explicitly state how the scientific quality of the studies influenced their conclusions.
- Answer: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated."
- Reasoning: The authors describe the statistical methods used to analyze the data, but do not mention any methods to combine the findings of the studies.
- Answer: [NA]

A10. Was the likelihood of publication bias assessed?
- Quote: Not applicable.
- Reasoning: The authors do not mention assessing the likelihood of publication bias.
- Answer: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of interest: None."
- Reasoning: The authors declare that there is no conflict of interest.
- Answer: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature"
- Reasoning: The title clearly identifies the report as a systematic review.
- Answer: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data. Methods: A review of literature was performed. N = 39 publications were reviewed. Results: For LILT and STEP, failure to achieve intestinal autonomy by conservative therapy represents the main indication, and end-stage liver disease the main contraindication. A sufficiently dilated intestinal segment is a common anatomical precondition for both procedures. STEP can be performed on shorter intestinal segments and on intricate segments such as the duodenum, which is technically not feasible for LILT. Both procedures have a similar extent of intestinal lengthening (approximately 70%) and result in improvement of enteral nutrition and reversal of complications of parenteral nutrition. STEP seems to have a lower mortality and overall progression to transplantation. Conclusions: STEP and LILT are both accepted procedures for non-transplant surgical management of SBS in children. The outcome after STEP seems to be more favourable, but larger series are needed to further assess accurate selection of eligible patients and to estimate effectiveness of procedures. A considerably higher number of cases for evaluation might be accomplished through the widespread use of a centralised registry."
- Reasoning: The abstract provides a structured summary of the background, objectives, methods, results, and conclusions.
- Answer: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Short bowel syndrome (SBS) is a serious disorder in which the intestinal resorptive capacity is insufficient to provide an adequate alimentary supply [1]. The estimated incidence in children is 24.5 per 100,000 live births with a higher incidence reported in preterm infants [2]. The estimated mortality is 2/100,000 population/year for children with SBS under 4 years [2] and 37.5% of neonates with SBS [3]. SBS in children occurs after congenital or acquired loss of part of the intestine [4], in most cases due to gastroschisis, necrotizing enterocolitis, mid-gut volvulus and intestinal atresia [5]."
- Reasoning: The authors provide a rationale for the review in the context of the current knowledge about short bowel syndrome.
- Answer: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The present review highlights most of these basic issues, first giving an overview of autologous intestinal reconstruction procedures with emphasis on LILT and STEP, then an insight into indications criteria for LILT and STEP and finally a comparison of associated outcome of both procedures from published data in children."
- Reasoning: The authors provide an explicit statement of the questions being addressed, including the participants (children), interventions (LILT and STEP), and outcomes (associated outcome of both procedures).
- Answer: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not applicable.
- Reasoning: The authors do not mention a review protocol or registration information.
- Answer: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "The articles were included in this review if they met the following criteria: Population: Studies of humans aged 0–18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included."
- Reasoning: The authors specify the study characteristics and report characteristics used as criteria for eligibility.
- Answer: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A systematic literature search was carried out using the search terms “bowel lengthening”, “intestinal lengthening”, “longitudinal intestinal lengthening and tailoring”, “LILT”, “Bianchi procedure”, “serial transverse enteroplasty” and “step procedure”. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
- Reasoning: The authors describe the information sources and the date of the last search, but do not specify the databases used.
- Answer: [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "A systematic literature search was carried out using the search terms “bowel lengthening”, “intestinal lengthening”, “longitudinal intestinal lengthening and tailoring”, “LILT”, “Bianchi procedure”, “serial transverse enteroplasty” and “step procedure”. The last search was done on December, 10th, 2012."
- Reasoning: The authors present the search terms used, but do not provide a full electronic search strategy for any database.
- Answer: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN)."
- Reasoning: The authors describe the process for selecting studies.
- Answer: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN)."
- Reasoning: The authors describe the method of data extraction from reports.
- Answer: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "In this analysis different parameters were evaluated. Preoperative data included age at surgery, intestinal anatomy, nutritional status, hepatic function and other co-morbidities. Intraoperative data included degree of intestinal lengthening and complications. Postoperative data included weaning from parenteral nutrition, weight and growth development, surgical complications, development of different preoperatively present conditions (liver damage, bacterial overgrowth, sepsis), intestinal redilatation, subsequent small bowel transplantation and mortality."
- Reasoning: The authors list and define all variables for which data were sought.
- Answer: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not applicable.
- Reasoning: The authors do not describe any methods used for assessing risk of bias of individual studies.
- Answer: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "The statistical analysis was performed using Microsoft Office Excel and SPSS 18.0 for Windows (SPSS Corp., Chicago, IL, USA). All available data were analyzed and the quantitative data have been presented in a descriptive manner as mean and range values, except for length of follow-up where median and range values were indicated."
- Reasoning: The authors state that the principal summary measures are mean and range values.
- Answer: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: Not applicable.
- Reasoning: The authors do not describe any methods of handling data and combining results of studies.
- Answer: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not applicable.
- Reasoning: The authors do not specify any assessment of risk of bias that may affect the cumulative evidence.
- Answer: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not applicable.
- Reasoning: The authors do not describe any methods of additional analyses.
- Answer: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "Using mentioned search terms, n = 4282 potentially relevant articles were identified and screened for retrieval. After excluding n = 4010 articles due to failure to meet selection criteria for the purpose of this review, n = 272 potentially appropriate articles were retrieved for more detailed evaluation. N = 233 articles were excluded with the following reasons: article language other than English or German; reports of patients older than 18 years; articles providing insufficient data; double publications and review articles. To the best of our knowledge, after considering our “Inclusion and Exclusion criteria”, finally n = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here (Table 1)."
- Reasoning: The authors give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, and provide a flow diagram.
- Answer: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "The median follow-up length in LILT reports was 51.8 months (6–111 months) [9,11,12,14,17–20,22–27,29–32], with reports of LILT series of even more than 20 years [9,23,32], while the median follow-up length in STEP reports was 23.0 months (12–68 months) [6,37,39–44], with maximum follow-up period of 5.7 years after STEP [43]."
- Reasoning: The authors present characteristics for each study, such as the median follow-up length, and provide the citations.
- Answer: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not applicable.
- Reasoning: The authors do not present data on risk of bias of each study.
- Answer: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "After LILT a mean of 71.5% (4%–100%) of follow-up suriviving patients could be weaned from PN in mean after 10.3 months (5–21 months) [9,15,17–21,23–32]. After STEP a mean of 58.1% (20%–100%) of follow-up suriviving patients could be weaned from PN in a mean time of 9.4 months (6–16 months) [6,20,37,39–44]."
- Reasoning: The authors present summary data and effect estimates for each study, but do not provide confidence intervals or a forest plot.
- Answer: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: Not applicable.
- Reasoning: The authors do not present results of a meta-analysis.
- Answer: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not applicable.
- Reasoning: The authors do not present results of an assessment of risk of bias across studies.
- Answer: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not applicable.
- Reasoning: The authors do not give results of additional analyses.
- Answer: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "LILT and STEP are accepted procedures for non-transplant surgical management of small bowel syndrome in children. Larger series are needed to further assess accurate selection of eligible patients and to estimate effectiveness of procedures. A considerably higher number of cases for evaluation might be accomplished through the widespread use of a centralised register."
- Reasoning: The authors summarize the main findings and consider their relevance to healthcare providers.
- Answer: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Nevertheless there are some limitations to be mentioned, as detailed evaluation of the impact of both procedures in children is limited by the nature of available reports."
- Reasoning: The authors discuss limitations at the review level.
- Answer: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "LILT and STEP are accepted procedures for non-transplant surgical management of small bowel syndrome in children. The outcome after STEP seems to be more favourable, but larger series are needed to further assess accurate selection of eligible patients and to estimate effectiveness of procedures. A considerably higher number of cases for evaluation might be accomplished through the widespread use of a centralised register."
- Reasoning: The authors provide a general interpretation of the results and implications for future research.
- Answer: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: "Acknowledgments: The authors are very grateful to “Heidelberger Stiftung Chirurgie” for supporting this publication."
- Reasoning: The authors describe the source of funding for the systematic review.
- Answer: [Yes]

95. Gallo 2012: Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up

LLM response

22 quote(s) from publication full text (mean similarity 100%)

A1. Was an 'a priori' design provided?
- Quote: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
- Reasoning: The authors clearly stated their research question and aim of the study.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any process of duplicate study selection or data extraction.
- Response: [No]

A3. Was a comprehensive literature search performed?
- Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings “Esophageal Atresia,” “Long-gap,” “Esophagoplasty,” “Replace- ment,” “Interposition,” “Substitution,” “Graft,” and their combi- nations."
- Reasoning: The authors described their search strategy, including the databases and keywords used.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention whether they included grey literature in their search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: "A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
- Reasoning: The authors mentioned the number of studies included but did not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
- Reasoning: The authors provided some characteristics of the included studies, such as the type of study and the number of patients.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any assessment of the scientific quality of the included studies.
- Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: No relevant quote found.
- Reasoning: The authors did not discuss the scientific quality of the included studies in their conclusions.
- Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "To perform the statistical overview Comprehensive Meta Analysis software (Version 2.2.064) was used. Data were com- puted using a random effects approach."
- Reasoning: The authors described the statistical methods used to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: No relevant quote found.
- Reasoning: The authors did not mention any assessment of publication bias.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of Interest None"
- Reasoning: The authors declared that there was no conflict of interest.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up"
- Reasoning: The title clearly identifies the report as a meta-analysis.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract Aim There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
- Reasoning: The abstract provides a structured summary of the study.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "There is still no consensus about the optimal surgical ap- proach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures."
- Reasoning: The authors provided the rationale for the review in the introduction.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
- Reasoning: The authors clearly stated the objectives of the review.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: No relevant quote found.
- Reasoning: The authors did not mention a review protocol or registration.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Included were prospective, retrospective, and comparative studies. Case reports, earlier reports of the series that were republished by the same center, review articles summarizing results of previous series, and the publications that did not provide sufficient data for the analyses mentioned above were excluded."
- Reasoning: The authors specified the study characteristics and report characteristics used as criteria for eligibility.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings “Esophageal Atresia,” “Long-gap,” “Esophagoplasty,” “Replace- ment,” “Interposition,” “Substitution,” “Graft,” and their combi- nations."
- Reasoning: The authors described the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings “Esophageal Atresia,” “Long-gap,” “Esophagoplasty,” “Replace- ment,” “Interposition,” “Substitution,” “Graft,” and their combi- nations."
- Reasoning: The authors presented their search strategy, including the databases and keywords used.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliogra- phies of relevant articles was done to identify publications for possible inclusion."
- Reasoning: The authors described the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe the data collection process.
- Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Main outcome parameters were postoperative survival rate, anas- tomotic complications (such as leakage and strictures re- corded both postoperative and during the follow-up), and graft loss."
- Reasoning: The authors listed and defined the variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe the methods used for assessing risk of bias in individual studies.
- Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "Relative risks (RRs) were computed using JI as the standard to which the other procedures were compared."
- Reasoning: The authors stated the principal summary measure used in the study.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "To perform the statistical overview Comprehensive Meta Analysis software (Version 2.2.064) was used. Data were com- puted using a random effects approach."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Response: [Yes]

P15. Methdos / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: No relevant quote found.
- Reasoning: The authors did not specify any assessment of risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe any additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
- Reasoning: The authors provided the numbers of studies screened, assessed for eligibility, and included in the review, but did not provide a flow diagram.
- Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI."
- Reasoning: The authors presented the characteristics of the included studies.
- Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: No relevant quote found.
- Reasoning: The authors did not present data on risk of bias within studies.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "Mortality is similar: postoperative survival rate after CI was 96%, after GPU 90.4%."
- Reasoning: The authors presented summary data and effect estimates for each study, but did not provide a forest plot.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "Mortality is similar: postoperative survival rate after CI was 96%, after GPU 90.4%."
- Reasoning: The authors presented the results of the meta-analysis, including confidence intervals.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: No relevant quote found.
- Reasoning: The authors did not present results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: No relevant quote found.
- Reasoning: The authors did not present results of any additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "GPU and CI appear comparable regarding the main outcomes of the present study: postoperative mortality, anastomotic compli- cations, and graft loss. GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal com- plications than CI."
- Reasoning: The authors summarized the main findings and considered their relevance to healthcare providers.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "There are few prospective series, amounting to only 37 patients. Well-designed pro- spective comparative studies are lacking, major and minor postoperative complications are sometimes not properly defined, follow-up data are often deficient and when pre- sented they are not homogenously described in the different studies."
- Reasoning: The authors discussed the limitations of the study.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Concluding, from this systematic review of the most recent experiences in esophageal replacement for LGEA and extensive corrosive strictures, no surgical approach emerges distinctly as the best procedure."
- Reasoning: The authors provided a general interpretation of the results and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: No relevant quote found.
- Reasoning: The authors did not describe the sources of funding for the systematic review.
- Response: [No]

96. Gosemann 2013: Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome

LLM response

24 quote(s) from publication full text (mean similarity 99.8%)

A1. Was an 'a priori' design provided?
- Quote: "Therefore, the aim of this study was to review the available data on long-term functional results in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal approaches with and without laparoscopy (L-TERPT and TERPT) reported in the recent literature."
- Reasoning: The authors clearly stated their research question and inclusion criteria before conducting the review.
- Response: [Yes]

A2. Was there duplicate study selection and data extraction?
- Quote: Not available.
- Reasoning: The text does not provide information on whether there was duplicate study selection and data extraction.
- Response: [No]

A3. Was a comprehensive literature search performed?
- Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
- Reasoning: The authors performed a systematic search on PubMed and screened reference lists for additional studies.
- Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
- Quote: Not available.
- Reasoning: The text does not provide information on whether grey literature was included in the search.
- Response: [No]

A5. Was a list of studies (included and excluded) provided?
- Quote: Not available.
- Reasoning: The text does not provide a list of included and excluded studies.
- Response: [No]

A6. Were the characteristics of the included studies provided?
- Quote: "A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT."
- Reasoning: The authors provided aggregated data on the participants and interventions of the included studies.
- Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
- Quote: Not available.
- Reasoning: The text does not provide information on whether the scientific quality of the included studies was assessed and documented.
- Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
- Quote: Not available.
- Reasoning: The text does not provide information on whether the scientific quality of the included studies was used in formulating conclusions.
- Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
- Quote: "With these data, a cumulative meta-analysis was performed to compare long-term outcome of patients who underwent OPEN surgery with patients who underwent L-TERPT/TERPT surgery."
- Reasoning: The authors used meta-analysis to combine the findings of the studies.
- Response: [Yes]

A10. Was the likelihood of publication bias assessed?
- Quote: Not available.
- Reasoning: The text does not provide information on whether the likelihood of publication bias was assessed.
- Response: [No]

A11. Was the conflict of interest included?
- Quote: "Conflict of Interest: None"
- Reasoning: The authors clearly stated that there was no conflict of interest.
- Response: [Yes]


P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- Quote: "Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome"
- Reasoning: The title clearly identifies the report as a systematic review.
- Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- Quote: "Abstract: Introduction Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed" [...] "Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
- Reasoning: The abstract provides a structured summary of the review.
- Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- Quote: "Various surgical procedures for the treatment of Hirschsprung disease (HD) have been proposed" [...] "Therefore, the aim of this study was to review the available data on long-term functional results in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal approaches with and without laparoscopy (L-TERPT and TERPT) reported in the recent literature."
- Reasoning: The introduction provides the rationale for the review in the context of what is already known.
- Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- Quote: "Therefore, the aim of this study was to review the available data on long-term functional results in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal approaches with and without laparoscopy (L-TERPT and TERPT) reported in the recent literature."
- Reasoning: The introduction provides an explicit statement of the research question with reference to participants, interventions, comparisons, and outcomes.
- Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Quote: Not available.
- Reasoning: The text does not provide information on whether a review protocol exists and where it can be accessed.
- Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- Quote: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
- Reasoning: The authors specified the study and report characteristics used as criteria for eligibility.
- Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
- Reasoning: The authors described the information sources used in the search.
- Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.”"
- Reasoning: The authors presented the electronic search strategy for PubMed.
- Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- Quote: "Only articles comprehensively describing the surgical methods (OPEN, L-TERPT, TERPT) and reporting on major outcome parameters (soiling/incontinence, constipation, enterocolitis, and/or stricture) were included in this study. Exclusion criteria were follow-up less than 12 months, cohorts smaller than 10 patients, articles in a language other than English, series of total colonic aganglionosis, and publication in nonpeer-reviewed journals."
- Reasoning: The authors stated the process for selecting studies.
- Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Quote: Not available.
- Reasoning: The text does not provide information on the method of data extraction from reports.
- Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Quote: "Data extracted from included articles were study characteristics (authors, journal, publication year, sample size, surgical technique, and follow-up period) and patient characteristics (age at surgery, extent of aganglionosis). Specific information on the outcome parameters constipation, enterocolitis, stricture, incontinence, and soiling were collected and analyzed."
- Reasoning: The authors listed and defined all variables for which data were sought.
- Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- Quote: Not available.
- Reasoning: The text does not provide information on the methods used for assessing risk of bias of individual studies.
- Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Quote: "With these data, a cumulative meta-analysis was performed to compare long-term outcome of patients who underwent OPEN surgery with patients who underwent L-TERPT/TERPT surgery."
- Reasoning: The authors stated that they performed a cumulative meta-analysis as the principal summary measure.
- Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
- Quote: "With these data, a cumulative meta-analysis was performed to compare long-term outcome of patients who underwent OPEN surgery with patients who underwent L-TERPT/TERPT surgery."
- Reasoning: The authors described the methods of handling data and combining results of studies.
- Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Quote: Not available.
- Reasoning: The text does not provide information on the assessment of risk of bias across studies.
- Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Quote: Not available.
- Reasoning: The text does not provide information on additional analyses.
- Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- Quote: "The initial literature search resulted in a total number of 148 articles published from 2008 to 2012. Of these, 130 articles were excluded because they did not fulfill the inclusion criteria. Eighteen articles finally met the inclusion criteria and were analyzed in detail."
- Reasoning: The authors gave numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
- Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- Quote: "A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT."
- Reasoning: The authors presented characteristics for which data were extracted for each study.
- Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Quote: Not available.
- Reasoning: The text does not provide data on risk of bias of each study.
- Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Quote: "The mean rate of constipation was 21% (range 0 to 59%) in the OPEN group compared with 10% (range 0 to 27%) in the L-TERPT/TERPT group" [...] "The mean rate of soiling/incontinence was 33% (range 10 to 75%) in the OPEN group compared with 25% (range 2 to 88%) in the L-TERPT/TERPT group" [...] "The mean frequency of enterocolitis was 14% (range 3 to 31%) in the OPEN group compared with 14% (range 0 to 34%) in the L-TERPT/TERPT group" [...] "Seven percent (range 0 to 21%) of children in the OPEN group developed an anastomotic stricture compared with 9% (range 0 to 43%) in the L-TERPT/TERPT group."
- Reasoning: The authors presented simple summary data for each intervention group and effect estimates for all outcomes considered.
- Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Quote: "With these data, a cumulative meta-analysis was performed to compare long-term outcome of patients who underwent OPEN surgery with patients who underwent L-TERPT/TERPT surgery."
- Reasoning: The authors presented the results of the meta-analysis done.
- Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).
- Quote: Not available.
- Reasoning: The text does not provide results of any assessment of risk of bias across studies.
- Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Quote: Not available.
- Reasoning: The text does not provide results of additional analyses.
- Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- Quote: "Functional outcome of different surgical techniques for HD is highly variable. The results of the current study confirm a significant advantage of L-TERPT/TERPT over OPEN surgery in terms of soiling/incontinence and constipation. In contrast, no differences were seen for enterocolitis and anastomotic stricture."
- Reasoning: The authors summarized the main findings and the strength of evidence for each main outcome.
- Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- Quote: "Although the present review of the recent literature revealed a higher incidence of constipation and soiling/incontinence after OPEN surgery compared with L-TERPT/TERPT, these data need to be carefully interpreted. The following limitations of the present analysis and validity of the data on the long-term outcome in the current literature may be discussed" [...] ""
- Reasoning: The authors discussed limitations at the study and review level.
- Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- Quote: "Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
- Reasoning: The authors provided a general interpretation of the results in the context of other evidence, and implications for future research.
- Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- Quote: Not available.
- Reasoning: The text does not provide information on the sources of funding for the systematic review.
- Response: [No]

97. Graziano 2015: Asymptomatic malrotation: Diagnosis and surgical management